Antibiotic Stewardship & Conservancy in Africa Sabiha Essack B. Pharm., M. Pharm., PhD South African Research Chair in Antibiotic Resistance & One Health School of Health Sciences, University of KwaZulu-Natal UKZN INSPIRING GREATNESS
Overview • Antimicrobial Resistance • African Context • Partners • Aim & Objectives • Study Design & Conceptual Framework • Progress against Outcomes • Envisaged Impact • Successes • Acknowledgements UKZN INSPIRING GREATNESS
AMR: A Global Public Health Emergency http://whqlibdoc.who.int/publications/2012/9789241503181_eng.pdf http://www.tufts.edu/med/apua/about_us/publications_21_3125925763.pdf UKZN INSPIRING GREATNESS
AMR (2): The Consequences www.jpiamr.eu/wp-content/uploads/2014/12/AMR-Review-Paper-Tackling-a-crisis-for-the-health-and-wealth-of-nations_1-2.pdf http://www3.weforum.org/docs/WEF_GlobalRisks_Report_2013.pdf UKZN INSPIRING GREATNESS
AMR: WHO Response 2001-15 WHO efforts on an-microbial resistance 2003 2012 2013 2001 2011 2014 2015 UKZN INSPIRING GREATNESS
The African Context http://apps.who.int/iris/bitstream/10665/112738/1/9789240692671_eng.pdf UKZN INSPIRING GREATNESS
The African Context (2) • The main cause of death in sub-Saharan Africa are communicable diseases (respiratory tract infection, diarrhoea and HIV/AIDS). • Antimicrobial resistance confounds the successful management of infectious diseases. • Capacities related to surveillance of antimicrobial use and resistance, infection control, drug legislation and distribution, veterinary sciences, health economy etc. are often limited in sub-Saharan Africa. UKZN INSPIRING GREATNESS
Partners UKZN INSPIRING GREATNESS
Aim To develop human capital and research capacity in a global health priority. i.e., the optimal management of infections in the context of antimicrobial stewardship and conservation. UKZN INSPIRING GREATNESS
Objectives • Strengthen research, curriculum development and pedagogical skills among academics, students and health professionals through design and implementation of online and research-based post-graduate training programmes (Masters & PhD) • Advance the optimal management of infections and improve key infection-related health statistics by conducting research to generate knowledge and evidence on the nature and extent of antimicrobial resistance with a view to designing context-specific interventions for its containment. UKZN INSPIRING GREATNESS
Study Design & Conceptual Framework GAP: SO2&4 GAP: SO3&4 3 Phases : antimicrobial socio- use and behavioral resistance factors 1. Situational Analysis 2. Curriculum GAP: SO1 GAP: SO2&3 Development for On- Antimicrobial policy and Line Masters stewardship curriculum health systems 3. Human Capital Development GAP: SO5 monitoring and gender evaluation UKZN INSPIRING GREATNESS
Progress Against Outcomes : Strengthened Higher Education Institutions • New Postgraduate Programmes approved/ offered: – ISCISA: Ministry of Education approved the research Masters and online M H Sc programmes for delivery in 2016 & 2017 respectively. – UNIMA: Intake into research-based M. Phil will occur in October 2016 and on the online M H Sc in 2017. • E-teaching and learning platform commissioned – Hardware purchased and commissioned • Faculty & Staff Development – Workshops on (1) e-teaching and (2) curriculum development for online programmes held. UKZN INSPIRING GREATNESS
Progress Against Outcomes : Strengthened Higher Education Institutions (2) • Faculty development: – ISCISA: 5/7 Masters & 5/5 PhD students are Faculty – UNIMA: 7/10 Masters and 1/2 PhD students are Faculty • Technical staff development – 2 IT personnel from each of ISCISA & UNIMA trained in (1) commissioning hardware, (2) operating systems & (3) Moodle • Administrative Staff Development – Finance Officer and Project Manager from ISCISA and Finance Office from UNIMA trained in financial management and reporting UKZN INSPIRING GREATNESS
Progress Against Outcomes : Strengthened Health Systems • Reference Laboratories commissioned. • Laboratory personnel trained in use of equipment • Practical workshops on antibiotic susceptibility testing held towards generating SoPs for surveillance. UKZN INSPIRING GREATNESS
Progress Against Outcomes : Enhanced Research Capacity/Competency • Workshops on (1) proposal writing and (2) statistical analysis held. • Team supervision has enhanced the supervision capacities of all supervisors. • Cohort supervision introduced. UKZN INSPIRING GREATNESS
Progress Against Outcomes : Human Capital Development Human Capital ISCISA UNIMA TOTAL GRAND TOTAL F M F M F M Masters Students 6 1 4 6 10 7 17 PhD Students 2 3 2 0 4 3 7 Faculty PG Students 7 3 3 5 10 8 18 Shadow Teachers 0 9 3 9 3 18 21 IT Staff 0 2 0 2 0 4 4 Administrative Staff 2 0 0 1 2 1 3 Laboratory Staff 2 2 1 1 3 3 6 UKZN INSPIRING GREATNESS
Progress Against Outcomes : Knowledge Generation to Inform Policy & Practice • Country situational analysis undertaken towards National Action Plans on AMR. • “Research Priority Setting” workshops held to inform research topics & contribute to National Health Research Agenda. UKZN INSPIRING GREATNESS
Progress Against Outcomes : Increased Participation & Stature of Women Participation by Gender Male Female 29 32 40 41 73 71 68 60 59 27 UKZN UiT ISCISA UNIMA TOTAL UKZN INSPIRING GREATNESS
Envisaged Impact Facilitate progress towards achieving SDGs by: • Creating a critical mass of Masters and PhD credentialed faculty & healthcare professionals, particularly women, with the requisite biomedical, clinical, social sciences and/or policy-related knowledge and skills to improve the capacity of health systems to manage infections and contain antimicrobial resistance & advance stewardship. Aligned with the African Union’s programmes: • Social Affairs: Health, Nutrition and Population • HR, Science and Technology • Women, Gender and Development Direct Indirect UKZN INSPIRING GREATNESS
Successes • Unequivocal endorsement by Ministries of Health and Education in both countries. • Strong commitment & facilitation by University leadership • Recognition by WHO AFRO as a flagship project with a view to replication in other African member states • Contributing to the Global Action Plan on AMR UKZN INSPIRING GREATNESS
Acknowledgements We are grateful to: • Professor Sundsfjord & UiT for convening this symposium. • NORAD for funding, freedom of choice in research areas and a capacity strengthening and developmental ethos at all levels. UKZN INSPIRING GREATNESS
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