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Fighting AMR demands collective action

It's been three years since the Uganda National Academy of Sciences issued a stern warning: antimicrobial resistance is alarmingly prevalent in our country.

With antimicrobials and antibiotics used broadly across farming, food processing, health care, wildlife management, and personal care, antimicrobial resistance (AMR) is not a problem that affects just a single sector.

Nor will a single sector solution be effective if we are to halt its progress. Yet at the end of the day, AMR does have a disproportionate impact in one sector: human health. HIV, respiratory illness, diabetes: while our resources and systems are strengthening year after year, they are increasingly strained by the double burden of infectious and non-communicable disease.

Layering in the added challenge of AMR further compromises the ability of the human body to recover from illness, as well as the ability of our health professionals to offer adequate, affordable, and accessible treatment.

This is precisely the reason why Makerere University College of Health Science, in partnership with One Health Central and Eastern Africa, is convening the third-ever national AMR conference in November, focused on solutions to Uganda's AMR challenges before it's too late to correct course.

Uganda is in need of a national action plan that brings together leaders and implementers across relevant sectors to establish a mechanism of unity and accountability, ensuring all hands are working together with aligned action to create meaningful progress in curbing AMR.

And with long-term improvements in Ugandans' health contingent on solving the AMR threat before it becomes a true crisis, the timing couldn't be better for collective action.

What must collective action to stop AMR look like? For Seed Global Health, we believe it starts with people – specifically the health professionals seeing and battling AMR on the front lines of our clinics and hospitals every day.

Working with partners across Uganda as well as the World Health Organization, we hope to strengthen education for health professionals – including physicians, nurses, and midwives – by taking concrete steps to translate education into practice to stem the spread of AMR.

We see health professionals as agents of change in three ways.

First, health care professionals across Uganda are seen as experts in this domain. Beyond their prescribing role, they have credibility, skill, and rapport with communities and families. Every interaction with a trusted health professional can be an opportunity share the information, as these community leaders are a conduit for information.

Second, many health professionals are prescribers. When well-trained and well-supported, each health professional has the power to make more judicious use of antimicrobials.

Where an antimicrobial isn't needed, we need health professionals to utilize the great and appropriate alternatives that can be substituted, and that requires continuing education and training on suitable alternatives.

And third, health professionals also play a role in research and inter-sectoral collaboration. There are health-trained professionals that work across sectors, including in policy or in non-prescribing roles, who can serve as a bridge for collective action, ensuring a multi-sector plan truly integrates across otherwise siloed domains.

By emphasizing the value of health professionals in efforts to combat AMR, we have an opportunity to further train competent prescribers. They are the people who will advocate for strong stewardship at a local level and will continue to serve as leaders who connect to communities today.

And they will go on to lead future national policy efforts tomorrow. Working directly at the patient interface, the health professionals Seed works to support and train see first-hand how AMR is making it harder to improve health in Uganda.

But by connecting the clinic, the classroom, and collective policy action, health professionals can be an important force to accelerate grassroots change and generate momentum necessary to keep Uganda moving toward eliminating AMR.

The author is the Uganda country director, Seed Global Health

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