Strengthen antibiotics control

Sir Alexander Flemmings 1945 Nobel Lecture predicted the emergence of antibiotic-resistant microbes.

The looming crisis is critical, particularly in low-income countries like Malawi where it becomes imperative to establish stringent regulations for antibiotic drugs to ensure public safety and safeguard the effectiveness of medical treatments.

In Malawi, the Pharmacy, Medicines and Poisons Board is the drug regulatory authority established through Parliament’s Act of 1988.

It regulates medicines, upholds pharmacy practices and enforces existing legal provisions.

Recognising the urgency for change, the board identified the need to repeal the 1988 law and introduce the Pharmacy and Medicine Regulatory Authority Act to bolster its ability to control and regulate illegal marketing of drugs.

The cabinet approved the proposed law in April 2018 and tabled it in Parliament in June of the same year.

The Bill was thoroughly examined by the Parliamentary Committee on Health.

To serve Malawians better, the board initiated several crucial reforms under the Malawi Public Sector Reforms Programme launched in 2015.

A significant reform introduced by the board was the Tip-Offs Anonymous Programme, a reporting and reward system designed to curb the prevalence of illegal drug vending, among others.

Of course, drug regulation and privatisation of drugstores, veterinary shops and pharmacies is critical to antibiotic misuse and resistance.

A study of antibiotic use practices in small-scale farming in Blantyre by John Mankhomwa and others revealed that shops distribute antibiotics without proper prescriptions.

Long-term surveillance by The Malawi-Liverpool-Welcome Trust Clinical Research Programme at Queen Elizabeth Central Hospital in Blantyre from 1998 to 2016 indicated that a number of germs isolated from patients displayed resistance to the country’s first-line antibiotics such as amoxicillin, penicillin, chloramphenicol, co-trimoxazole and ciprofloxacin.

Strolling through markets and trading centres, numerous pharmacies, drugstores and veterinary shops dispensing antibiotics flash past.

One wonders if all these establishments are duly registered under the authority to sell drugs.

The proliferation of drug-selling points, coupled with poor regulation, contributes to the pervasive problem of antibiotic misuse and resistance.

These establishments, which provide essential services, have inadvertently become enablers of a growing crisis.

A key factor exacerbating this issue is the unrestricted availability of antibiotics without stringent prescription requirements.

Often, individuals can simply walk into these facilities and purchase drugs without the guidance of a qualified professional.

Easy access to antibiotics empowers individuals to self-medicate, often without a proper understanding of the appropriate dosage, duration, or necessity of the treatment.

Nevertheless, sellers promote the sale of antibiotics, even inappropriately, in pursuit of financial gains.

This profit-driven practice not only compromises patient safety but also ramps up antibiotic-resistant strains.

Also, the misuse of antibiotics is an escalating concern in the veterinary field.

Here in Malawi, the situation is fuelled by the scarcity of veterinarians. This contributes to the widespread misuse of antibiotics in the livestock sector.

Regrettably, ordinary people purchase drugs and administer them to animals without veterinarian knowledge.

This does not only results in the inappropriate use of antibiotics but also raises serious concerns about antibiotic residues in food products.

This leads to the transmission of antibiotic-resistant pathogens across species boundaries.

Curbing escalating antibiotic misuse and preserving the effectiveness of these vital drugs is essential for our low-income country.

Drug regulators must urgently reinforce regulations and promote responsible antibiotic distribution to combat this growing threat. 

It is imperative for the regulatory board to take proactive measures and conduct thorough inspections of antibiotics sold in private establishments to ensure the implementation of effective regulatory measures.