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Government policy interventions to reduce human antimicrobial use: A systematic review and evidence map

Van Katwyk, S. R.; Grimshaw, J. M.; et al (2019) C2

BACKGROUND: Growing political attention to antimicrobial resistance (AMR) offers a rare opportunity for achieving meaningful action. Many governments have developed national AMR action plans, but most have not yet implemented policy interventions to reduce antimicrobial overuse. A systematic evidenc...e map can support governments in making evidence-informed decisions about implementing programs to reduce AMR, by identifying, describing, and assessing the full range of evaluated government policy options to reduce antimicrobial use in humans. METHODS AND FINDINGS: Seven databases were searched from inception to January 28, 2019, (MEDLINE, CINAHL, EMBASE, PAIS Index, Cochrane Central Register of Controlled Trials, Web of Science, and PubMed). We identified studies that (1) clearly described a government policy intervention aimed at reducing human antimicrobial use, and (2) applied a quantitative design to measure the impact. We found 69 unique evaluations of government policy interventions carried out across 4 of the 6 WHO regions. These evaluations included randomized controlled trials (n = 4), non-randomized controlled trials (n = 3), controlled before-and-after designs (n = 7), interrupted time series designs (n = 25), uncontrolled before-and-after designs (n = 18), descriptive designs (n = 10), and cohort designs (n = 2). From these we identified 17 unique policy options for governments to reduce the human use of antimicrobials. Many studies evaluated public awareness campaigns (n = 17) and antimicrobial guidelines (n = 13); however, others offered different policy options such as professional regulation, restricted reimbursement, pay for performance, and prescription requirements. Identifying these policies can inform the development of future policies and evaluations in different contexts and health systems. Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review. CONCLUSIONS: To our knowledge this is the first study to provide policy makers with synthesized evidence on specific government policy interventions addressing AMR. In the future, governments should ensure that AMR policy interventions are evaluated using rigorous study designs and that study results are published. more

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Standard Treatment Guidelines. Nigeria

Federal Ministry of Health Nigeria , World Health Organisation (WHO) (2008) C_WHO

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Improving medicines access and use for child health: a guide to developing interventions

Ross-Degnan, D., Vialle-Valentin, C., and Briggs, J. USAID, SIAPS (Systems for Improved Access to Pharmaceuticals and Services) (2015) C1

Submitted to the US Agency for International Development by the Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program. This manual provides a framework to identify problems and design interventions to improve access to and use of medicines for children. It is a resource for ... more

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Zimbabwe National Pharmacovigilance Policy Handbook, 2nd ed.

Medicines Control Authority of Zimbabwe (MCAZ) | Ministry of Health and Child Care (2016) C2

The Zimbabwe National Pharmacovigilance Policy Handbook, 2nd Edition updates the November 2013 version to indicate the Zimbabwe National Pharmacovigilance (PV) Centre’s compliance with the WHO Pharmacovigilance Indicators Handbook 2015.

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The Pursuit of Responsible Use of Medicines

Sharing and Learning from Country Experiences (2012) C_WHO

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Kenya: Multiple Indicator Cluster Survey 2013/14 Key Findings

Kenya National Bureau of Statistics, UNICEF (2015)

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Kenya: Multiple Indicator Cluster Survey 2013/14, Final Report

Kenya National Bureau of Statistics, UNICEF (2016)

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Effect of Artesunate–Amodiaquine on Mortality Related to Ebola Virus Disease

Etienne Gignoux, M.P.H., Andrew S. Azman, Ph.D., Martin de Smet, M.D., et al. (2016) C2

New England Journal of Medicine 374:1,pp23-32

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Libyan Essential Medicines List - 1st Edition

Government of Libya (2022) C1

The pharmaceutical sector of any nation is responsible for providing society with quality medicines and other pharmaceutical services. According to the World Health Organization (WHO), Pharmaceuticals may constitute as much as 40% of the national health budget in developing countries, yet portions o... more

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Assessment of Medicines Quality Assurance in Rwanda: Overview of Findings and Recommendations for Consideration

Coignez, V., Hajjou, M., and Smine U.S. Agency for International Development (USAID) (2009) C2

PQM conducted an assessment of the medicine quality assurance and quality control systems in Rwanda during November 9-13, 2009. Medicine quality assurance remains to be developed in Rwanda: the country has neither a medicine regulatory authority (MRA) nor a national medicine quality control laborato... more

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Investigation of the Quality of the 12 Most-Used Antibiotics Available in Retail Private Pharmacies in Rwanda

Bizimana, T.; Kagisha, V.; Nyandwi, J.B: et al. MDPI Antibiotics (2022) CC

Antibiotics 2022, 11(3), 329; https://doi.org/10.3390/antibiotics11030329. The authors found that the most-represented antibiotics on the Rwandan market were amoxicillin, co-trimoxazole and cloxacillin. No counterfeit antibiotics were found in this study. However, substandard batches with moderate ... more

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Senegal private health sector assessment: Selected health products and services

Brunner B., J. Barnes, A. Carmona et. al. United States Agency for International Development (2016) C2

SHOPS and HIA finalized a scope of work with USAID Senegal in April 2015, and a team of five private sector experts conducted the onsite assessments between May and June 2015. The Private Sector Assessment (PSA) team worked closely with Senegalese key stakeholders throughout the process. The PSA tea... more

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Pharmaceutical Services in Mozambique: foreign aid in public provision of medicines

Sachy, M; Almeida C; Pepe VLE (2018) CC

This article examines the activities of national and international actors in Pharmaceutical Services (PS) in Mozambique from 2007 to 2012, focusing on the public provision of HIV/Aids, malaria and tuberculosis medicines. It describes how PS functions in the country, what actors are involved in this ... more

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Comparative Analysis of Pharmacovigilance Systems in Five Asian Countries

Nwokike J., Ludeman E., Thumm M. USAID, SIAPS (2013) C1

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The State of the World’s Antibiotics Report 2021

Siriam, A.; et al. The Center For Disease Dynamics, Economics & Policy CDDEP (2021) CC

A Global Analysis of Antimicrobial Resistance and Its Drivers. Since the first State of the World’s Antibiotics report in 2015, antimicrobial resistance has leveled off in some high-income countries but continues to rise in many low- and middle-income countries (LMICs), where access to antibiotic... more

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Report of the Task Force on Conservation & Sustainable use of Medicinal Plants

Government of India, Planning Commission (2000) C1

Medicinal plants occupied an important position in the socio-cultural, spiritual and medicinal arena of rural people of India. T The present report is based on contribution made by members of the task force and many other experts on medicinal plants. We hope the report on implementation will promot... more

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The availability, prices and affordability of essential medicines in Malawi: A cross-sectional study

Khuluza, F.; Haefele-Abah, C. PLoS ONE (2019) CC

The Malawian government recently introduced cost-covering consultation fees for self-referral patients in tertiary public hospitals. Previously, patients received medicines free of charge in government-owned health facilities, but must pay elsewhere. Before the government implements a payment policy... more

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Kenya Pharmaceutical Sector Development Strategy

United Nations Industrial Develoopment Organization (2012) C1

Global UNIDO Project: Strengthening the local production of essential medicines in least developed and developing countries