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Beyond the pill: Rwanda’s path to curbing Antimicrobial Resistance

By Sam K Nkurunziza
On 17 November 2024 at 06:28

Antimicrobial Resistance (AMR) is a significant global health threat with far-reaching consequences. The World Health Organization (WHO) lists it among the top 10 health threats, warning that over 1.27 million deaths in 2019 alone were due to drug-resistant infections.

If current trends continue, AMR could lead to as many as 10 million deaths annually by 2050. Statistics show that economically, AMR could cost the global economy $3.4 trillion each year while pushing millions into poverty.

For low- and middle-income countries with healthcare systems already under strain, the need for coordinated, strategic responses is urgent.

From a layman’s understanding, AMR occurs when bacteria, viruses, fungi, and other microorganisms evolve to resist the drugs designed to kill them. Over time, these “superbugs” render standard treatments ineffective, harder and sometimes impossible.

Dr. Eric Mugabo, a Rwandan Public Health activist and The Executive Director of Oazis Health, explains that AMR doesn’t discriminate; it’s a global issue that affects everyone. Human daily actions ranging from handwashing to responsible antibiotic use, play a critical role in fighting AMR.

Rwanda is addressing AMR through antimicrobial stewardship, a strategy designed to promote the responsible use of antimicrobials in order to preserve their effectiveness. This means ensuring antibiotics and other antimicrobials are used correctly and only when necessary.

Healthcare professionals attending Antimicrobial Stewardship training

Consuming these antimicrobials without professional guidance increases chances of developing AMR since misuse and overuse are primary drivers. It means that healthcare providers are key players in ensuring that medications like antibiotics are administered with care to avoid fueling resistance.

Through its Antibiotic Stewardship Program, Oazis Health and partners have developed initiatives to equip Rwandan healthcare professionals to become effective antimicrobial stewards.

This training emphasizes on understanding AMR from a scientific perspective, best practices for antibiotic prescribing, and patient engagement on responsible medication use.

Oazis Health offers an online, CPD-accredited course available to clinicians and para-clinicians across Rwanda. Through this course, healthcare providers gain insights into AMR drivers and effects, learning how to incorporate antimicrobial stewardship principles into their daily clinical practice.

“Stewardship isn’t just about prescribing less; it’s about understanding when and why to use antimicrobials to balance their benefits while minimizing risks “Through education, we’re empowering healthcare providers to be guardians of these vital medicines,” says Dr Mugabo.

Rwanda’s healthcare workers increasingly recognize that every prescription matters in the fight against AMR and are learning to engage patients on responsible antibiotic use.

OAZIS Health conducting a workshop for University of Rwanda, Huye Campus students.

Public awareness is another critical strategy in containing AMR as recommended by the WHO. In collaboration with the University of Manchester, Oazis Health recently organized the “30 Days of Antibiotic Stewardship” campaign, designed to engage the public and raise awareness about AMR.

The campaign used an online course called Antibiotics and You, encouraging participants to learn about AMR and motivate others to take the course. Instead of relying on social media “likes,” the campaign measured engagement by the number of course certificates participants earned and shared online.

One standout participant was Felix Nahimana, a medical student at the University of Rwanda, who mobilized over 100 individuals to complete the course. He reflected on and shared his experience.

“Through this course, I understood the seriousness of AMR. As a future doctor, I’m committed to raising awareness and using social media to combat the spread of superbugs.”

The campaign’s hashtag-driven format allowed participants to spread key messages on hygiene, the dangers of self-prescribing antibiotics, and the global threat of resistance.

Despite these promising efforts, Rwanda faces challenges in its fight against AMR. Public awareness of AMR remains low, diagnostic resources are limited, and antibiotics are often purchased without prescription, which increases misuse.

Rwandan Medical Doctors have pledged to preserve antimicrobials.

Dr. Mugabo highlights the importance of addressing these gaps: “We’re making strides, but there’s a real gap in public understanding and policy enforcement. Rwandans need to understand that self-prescribing antibiotics or using them when unnecessarily contributes to AMR, impacting everyone in the long term.”

Experts agree that a multifaceted approach is essential to combat AMR effectively. For Rwanda, this includes increasing investments in Water, Sanitation, and Hygiene (WASH) in healthcare settings, raising public awareness, enforcing strict regulations around antibiotic prescriptions, and providing healthcare workers with proper diagnostic tools and training.

Dr Mugabo underscores the importance of collaboration: “Only by embracing the One Health approach and partnering with academic institutions, government bodies, and community organizations can we sustain change and successfully mitigate AMR’s impact.”

Oazis Health has ambitious plans to expand its impact. The organization aims to establish a regional Antimicrobial Stewardship Hub, dedicated to education, clinical training, and public awareness.

This hub would serve as a center for AMR knowledge and advocacy, connecting healthcare professionals with resources on AMR best practices.

Additionally, an online platform for AMR-related content is operational, with plans to collaborate with other media outlets to keep AMR a visible issue within the community.

These efforts are designed to build a foundation of knowledge, awareness, and responsible action against AMR in Rwanda and the wider region.

The battle against AMR requires sustained collaboration across all levels of society. While Rwanda advances its healthcare system, the commitment of healthcare professionals, activists, and community members provides a promising foundation.

Rwanda’s growing focus on antimicrobial stewardship and public engagement may pave the way for a healthcare system equipped to confront the silent but deadly threat of antimicrobial resistance.


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