Youth symposium ignites creativity in preventing antimicrobial resistance
More than 80 students from 10 tertiary institutions in Uganda gathered in Kampala on 3-4 March 2023 to discuss their role in mitigating antimicrobial resistance (AMR). The ‘My turn’ symposium provided a platform for learning across various disciplines and showcased innovative AMR prevention and reduction solutions in line with the 2022 World Antimicrobial Awareness Week (WAAW) theme, ‘Preventing antimicrobial resistance together’.
AMR occurs when medicines are no longer effective against microorganisms such as bacteria, fungi, viruses and parasites, making infections harder to treat and increasing the risk of disease spread, severe illness and death. If not appropriately addressed, common infections, minor injuries and routine elective surgery could be associated with life-threatening risks. AMR is a significant threat to public and environmental health and its impact is a key concern in sectors such as human and animal health, agriculture and wildlife.
Symposium attendees, drawn from the Antimicrobial Resistance Leadership Program (AMRLEP), discussed gaps that have hindered AMR control in Uganda, the roles of different stakeholders as well as what can be done to better address the issue. Unfavourable regulatory frameworks, poor reporting on antimicrobial sale and use, poor disposal and waste management of veterinary medicines and use of antimicrobials in animal feeds were some of the challenges identified. Others were poor public awareness of the effects of abuse and misuse of antimicrobials and limited funding to address AMR.
‘Everyone has a part to play in addressing the AMR problem. Simple and basic interventions like infection prevention and control can have a significant impact in preventing the spread of infections in health institutions,’ ReAct Africa director Mirfin Mpundu said.
ReAct Africa in partnership with Students Against Superbugs-Africa piloted AMRLEP for tertiary students in Africa in 2021.The program recognizes the role of young people in the AMR fight as future microbial prescribers, users, stewards and policymakers. More than 90 students from eight African countries have enrolled in AMRLEP, training to engage in AMR initiatives such as forming AMR One Health clubs, research, awareness creation and community engagement.
Government-led approaches to AMR in Uganda include the creation and implementation of the AMR National Action Plan, which provides for the establishment of the National One Health Platform (NOHP), capacity building among partners and stakeholders, active and passive surveillance, community engagement and awareness creation. Speakers at the symposium, however, reiterated the need for increased public awareness, focusing on using simple language to frame the problem and solutions. Other proposed action areas included generating, using and sharing local data among stakeholders, tightening regulation to promote appropriate antimicrobial use, as well as promoting institutional collaboration.
Emmanuel Isingoma from the Ministry of Agriculture, Animal, Industries and Fisheries (MAAIF) and a member of NOHP, noted ‘the need to have local data, so that global numbers are not used to address local problems.’ He also stressed the importance of research that is relevant to local problems, providing actionable data to policymakers, as well as ensuring adequate funding for AMR intervention efforts.
The use of local studies to inform policy was echoed by Denis Byarugaba, a microbiologist based at Makerere University, who spearheaded the development of the Uganda AMR National Action Plan (NAP): ‘For example, research conducted at Masaka Hospital showed that there was very high exposure to AMR pathogens among healthcare workers so transmission into the community was very high. Another study found Salmonella (a well-known foodborne human pathogen) along the water supply line, even after treatment, meaning that treatment was not effective.’
Citing the role of professionals in addressing AMR, the microbiology professor emphasized the importance of expanding education and training on AMR to include not only human, animal, plant and environment health professionals, but also behavioural scientists and the media. This, he said, would promote the spread of healthy behaviours and discourage risky ones in the population.
Betty Mbolanyi from the Ministry of Water and Environment reiterated the need for a multisectoral, One Health approach to address the global challenge posed by AMR. She said the devastating effects on national economies and their healthcare systems was likely to get worse in low- and middle-income countries if not contained.
‘Ongoing research has identified AMR in the environment. Activities in health facilities, farms, and industries affect the environment and the effects may not be visible for a while. Unfortunately, the environment has been neglected for a long time and studies show that it is stressed,’ said Mbolanyi.
To address the limited resources available for AMR-related activities, participants called for creativity in awareness creation and stakeholder engagement. Students showcased this ingenuity in their entries to a competition on AMR mitigation in categories such as innovation and research, community engagement and art.
Some of the innovations presented at the forum were information technology applications and information systems that aimed to digitize healthcare, simplify patient follow-up and improve access to AMR-related information. Community awareness campaigns, alternative protein sources for livestock, school outreach programs and a skit were also on the program. All these were evaluated on criteria that included originality, creativity and uniqueness, problem articulation and methodological soundness.
After a rigorous judging process, Kabale University was declared the overall winner for a skit that illustrated the impact of antimicrobial abuse and the resulting AMR. The team will be supported to refine their skit and present it at AMR forums.
The event was organized by ReAct Africa, Students Against Superbugs Africa, and the International Livestock Research Institute (ILRI)-led One Health Research, Education and Outreach Centre in Africa. Other participants at the symposium included representatives from the National One Health Platform comprising of the ministries of Health, Water and Environment, Agriculture, Animal, Industries and Fisheries, as well as representatives from the World Health Organization, the Food and Agricultural Organization of the United Nations and academia.