Health experts raise alarm: Call for strict law enforcement

The Pharmaceutical Society of Ghana (PSGH) has called on the Pharmacy Council and the Food and Drugs Authority (FDA) to tighten regulation on medicines used to prevent and treat infectious diseases in humans, animals and plants to ensure that only those who have prescriptions can access them.

Also, such medicines, technically known as antimicrobials, should be available only to pharmacies which are the only entities allowed to stock and dispense them.

It said antimicrobials, which include antibiotics, antivirals, antifungals, and antiparasitics, should never be treated like over-the-counter (OTC) medicines.

The PSGH stressed that OTC medicine sellers, popularly referred to as drug stores or chemical sellers, should immediately stop stocking, dispensing or selling antibiotics as that was prohibited by law.

“We, therefore, call on the Pharmacy Council and the FDA to ensure that the necessary laws and regulations are enforced and antibiotics are dispensed only in pharmacies by pharmacists as the law requires,” it said.

This was contained in a message entitled: “Call to action on the management and use of antimicrobials”.

It was read by the President of PSGH, Dr Samuel Kow Donkoh, in Accra last Thursday, November 23, as part of activities to commemorate the 2023 World Antimicrobial Resistance (AMR) Awareness week.

For the Ghana Veterinary Medical Association (GVMA), the situation called for intense education on the proper use of antibiotics so that their usage does not compromise the system of individuals.

Professor Raphael Folitse of the Kwame Nkrumah University of Science and Technology (KNUST) School of Veterinary Medicine, who made the call at the 49th Annual General Meeting (AGM) and 24th Biennial Conference of GVMA, said research by scientists had revealed that people would die every three seconds by the year 2050, if nothing was done to address the abuse of antibiotics.

Antimicrobial resistance

Antimicrobial resistance occurs when disease-causing germs stop responding to frequently prescribed antimicrobial medicines.

This jeopardises the ability to treat common infections, increases the cost of treatment, disrupts the progress made in combating diseases, posing a grave challenge to communities, health systems and economies.

Every year, the international community observes World AMR Awareness Week from November 18 to 24 to raise awareness of the risks posed by the inappropriate use of antimicrobial medicines in humans, animals and crops and encourage their responsible use to reduce the emergence and spread of AMR.

The theme for this year is, ‘Preventing antimicrobial resistance together’.

Cold, cough, flu

Dr Donkoh further urged the general public to desist from taking antibiotics to treat cold and flu symptoms.

“When you have cough, cold and sore throat, antibiotics should not be your first choice. Do not go to your doctor, pharmacist, OTC seller, demanding antibiotics for treatment of cough and sore throat,” he said.

“OTC medications are adequate to help relieve most of these symptoms. These conditions are not conditions to be managed by antibiotics as we do presently,” Dr Donkoh advised.

Giving a similar advice on antimalarial medications, he said until the patients had tested and proven that they were positive for malaria, they should not take antimalarial treatment, as stated in the national policy.

Citing antimalarial medication among antimicrobials, the president of the PSGH said if people did not stick to the principles and policies guiding those medications, they would end up having resistance, just as it had been with previous antimalarial medications such as chloroquine, sulfadoxine and pyrimethamine, commonly sold under the name Fansidar.

He said when that happened, it would be difficult to tell what the future would be for the treatment of the ailment, especially because very few investment was going into the discovery and development of new classes of antimicrobials.

Developing new antibiotics

Dr Donkoh explained that the process of developing a new antibiotic was time-consuming and financially burdensome, as it took about 10 to 15 years, costing over $1 billion.

That dearth of innovation, the PSGH president pointed out, made them vulnerable as the arsenal against microbial infections stagnated in the face of evolving AMR threats.

“In the face of these staggering figures, it is evident that we stand at a critical juncture. Our response to AMR must, therefore, be swift, coordinated and unwavering,” Dr Donkoh stated.

As the country joins the world to commemorate the 2023 World AMR Awareness Week, he reminded all that everyday choices of today would shape the health and well-being of generations to come.

“This is the admonition from the PSGH and a practical one to all patients that do not use the antimicrobials indiscriminately,” Dr Donkoh stressed.

He said the society would collaborate with stakeholders and the media to implement policies and content on adhering to infection prevention and control interventions.

Address root causes

The Technical Officer for Antimicrobial Resistance at the World Health Organisation (WHO), Ghana Office, Dr George Kwesi Hodidor, said in 2019, 1.27 million people died from AMR infections globally, more than HIV/AIDS and malaria combined.

He said sub-saharan African countries bore the highest burden of AMR-associated deaths at 99 deaths per 100,000 people and, therefore, called for urgent action to address the main causes of AMR.

Dr Hodidor listed the causes to include misuse and abuse of antimicrobial medicines; lack of access to clean water, sanitation and hygiene; poor infection prevention and control practices; inadequate use of vaccines to decrease infections; inadequate laboratory capacity including equipment and reagents to guide proper treatment; poor waste disposal practices and the presence of antimicrobials in food-animal production and crop protection.

The Director of Pharmaceutical Services at the Ministry of Health, Dr Joycelyn Azeez, said AMR made infections harder to treat and increased the risk of disease spread, severe illness and death.

The media must use their platforms to encourage responsible antibiotics use, she said and also emphasised the importance of completing prescribed medicines and discourage self-medication.

The Deputy Registrar, Operations at the Pharmacy Council, Dr Daniel Amaning Danquah, urged the public to report any OTC seller that stocked or dispensed antibiotics to the council for action to be taken.

Prof. Folitse, during the address, said: “Some of the antibiotics can easily treat some diseases, but if they are not properly used, it will come to a time when the same antibiotics do not work because the disease-causing agent or germs get used to the antibiotics”.

Speaking on the theme: “One Health in Zoonosis Control in Ghana: Repositioning Veterinary Services for Maximum Impact”, he said health professionals must, therefore, be educated on how to properly administer antibiotics.

Prof. Folitse said zoonotic diseases — which are infections that are spread between people and animals — posed a significant threat to global health, food security and the economy worldwide.

“To successfully prevent and control zoonoses, health professionals and their related institutions and disciplines must work together — an approach that is referred to as ‘One-Health’,” Prof. Folitse said.

Zoonotic diseases

The reorganisation of the Planting for Food and Jobs programme is placing emphasis on enhancing the various commodity value chains, with prioritisation of the poultry value chain, particularly the broiler value chain, to address the challenges affecting the efficiency in the sector.

The President of the GVMA, Dr Cyril Quist, said building a database of all farmers in areas of flock numbers, mortality and vaccinations, among others, should be prioritised to know in real-time, gaps and deficits in production parameters for early response and attention.

He said active surveillance structures should also be put in place for the country to be ahead of any disease outbreak.

Dr Quist also wants the government to subsidise vaccines required for vaccine-preventable diseases such as anthrax as a poverty alleviation intervention.

Equip laboratories

The Ministry of Food and Agriculture would support the disease surveillance, control and management of animal diseases capacities and capabilities of the Veterinary Services Department (VSD) by equipping its laboratories to lead and collaborate with stakeholders within the ‘One-Health’ concept, the Minister of Food and Agriculture, Dr Bryan Acheampong, said in a speech read on his behalf.