CwPAMS Extension Programme (2021-2022)

CwPAMS aims to leverage the expertise of UK health institutions and technical experts to strengthen the capacity of the national health workforce and institutions in Commonwealth countries to address antimicrobial resistance (AMR) challenges. More information on CwPAMS and the projects funded in the first round of the grant programme is available here.

Grants allocated under the CwPAMS extension placed a central focus on antimicrobial stewardship (AMS) and on developing pharmacy expertise and capacity whilst incorporating and expanding the findings from other infection prevention and control initiatives and strengthening capacity of using clinical microbiology data.

The programme involved Health Partnerships operating in the following 8 countries:

Ghana | Kenya | Malawi | Nigeria | Sierra Leone | Tanzania | Uganda | Zambia

The programme’s aims were to achieve:

• Effective implementation of AMR/AMS interventions and strategies, with standardised tools and guidance being used by local institutions and/or national partners.
• Institutions and workforce demonstrate improved knowledge and practice related to AMS prescribing practice.
• NHS staff demonstrate improved leadership skills and a better understanding of the global context of AMR in their work.

These aims were addressed through:

1. Antimicrobial stewardship (AMS), including surveillance.
2. Utilising/developing pharmacy expertise and capacity.
3. Infection Prevention Control (IPC).
4. Strengthening capacity of using clinical microbiology data.

UGANDA

KamCamWIMN – Antimicrobial Stewardship and Infection Prevention Control

• Lead UK Partner: Cambridge University Hospitals (CUH)
• Lead LMIC Partner: Makerere University Department of Obstetrics and Gynaecology

Establish a Sustainable Centre of Excellence for Integrated AMS and IPC at Makerere University Hospital

• Lead UK Partner: Buckinghamshire Healthcare NHS Trust
• Lead LMIC Partner: Makerere University Health Services

Capacity Sharing for Antimicrobial Stewardship through the Medicines and Therapeutic Committee at Jinja Regional Referral Hospital

• Lead UK Partner: London School of Hygiene and Tropical Medicine
• Lead LMIC Partner: Infectious Disease Research Collaboration

Scaling-up interventions for strengthening antimicrobial stewardship in Wakiso district

• Lead UK Partner: Nottingham Trent University
• Lead LMIC Partner: Makerere University School of Public Health

GHANA

Enhancing Capacities of Healthcare Providers in the Practice of Antimicrobial Stewardship Programmes: The Role of Local Data and Safe Medicine Practices

• Lead UK Partner: University College London Hospitals (UCLH) NHS Foundation Trust
• Lead LMIC Partner: University of Health and Allied Sciences, Ho

Strengthening Antimicrobial Stewardship through improving surveillance and building sustainable capacity and capability in Ledzokuku Krowor Municipal Assembly [LEKMA] Hospital and LEKMA polyclinic

• Lead UK Partner: UK Faculty of Public Health (FPH)
• Lead LMIC Partner: Ghana Public Health Association

Development and Institution of Antimicrobial Stewardship in the University Hospital, Knust

• Lead UK Partner: Ulster University, Coleraine Campus, Northern Ireland
• Lead LMIC Partner: University Hospital, Knust

ZAMBIA

Developing optimal antimicrobial stewardship capacity and practice in rural and peri-urban healthcare settings in Zambia

• Lead UK Partner: University of Sussex; Brighton and Sussex Medical School
• Lead LMIC Partner: Hospital Pharmacy Association Zambia

Developing Reliable Systems and Practices for Antimicrobial Stewardship in a Hospital Setting in Eastern Province, Zambia: Modelled on Scottish-Ghana AMS programme

• Lead UK Partner: NHS Highland
• Lead LMIC Partner: Chipata Central Hospital

SIERRA LEONE

Institutionalising AMS at Connaught Hospital

• Lead UK Partner: King’s Global Health Partnerships, King’s College London
• Lead LMIC Partner: Connaught Hospital, University of Sierra Leone Teaching Hospital Complex

KENYA

Kakamega and Cambridge Partnership – Working to strengthen Antimicrobial Stewardship at Kakamega County Teaching and Referral Hospital

• Lead UK Partner: Cambridge University Hospital NHS Foundation Trust
• Lead LMIC Partner: Kakamega County Referral Hospital

TANZANIA

Building the KCMC-NHCFT antimicrobial stewardship partnership

• Lead UK Partner: Northumbria Healthcare NHS Foundation Trust (NHCFT)
• Lead LMIC Partner: Kilimanjaro Christian Medical Centre

MALAWI

Training pharmacists as antimicrobial stewardship leads in Malawi

• Lead UK Partner: Betsi Cadwaladr University Health Board
• Lead LMIC Partner: Pharmaceutical Society of Malawi

NIGERIA

Building capacity of healthcare workers for AMS at a university teaching hospital in Lagos

• Lead UK Partner: UK Faculty of Public Health (FPH)
• Lead LMIC Partner: College of Medicine of the University of Lagos (CMUL)

AMR poses a catastrophic threat to us all and yet until recently it has remained a neglected area of global health.

A number of factors can increase the spread of resistant microorganisms. For example, antimicrobial drugs are often used unnecessarily, which increases the risk that microorganisms can become resistant, survive and multiply. In 2016, 490,000 people developed multi-drug resistant TB, and drug resistance is starting to complicate the fight against HIV and malaria as well.

The independent Review on antimicrobial resistance estimated that,

at least 700,000 deaths each year globally are attributable to drug resistance to infections including bacterial infections, malaria and HIV/AIDS.

Unless action is taken, it is thought the burden of deaths from AMR could balloon to 10 million lives each year by 2050 and cost the global economy up to $100 trillion US Dollars.

It is estimated that 5000 deaths are already caused every year in the UK alone because antibiotics no longer work for some infections.

Rising drug resistance is a global hazard and if we do not tackle it, every day procedures such as caesarean sections, cancer therapy, and hip replacements will become extremely dangerous.