Tackling misuse of antibiotics in Solomon Islands
At just 2 months old, baby Florida Berelia started to have difficulty breathing at her home in Alligator Creek, a community 13 kilometres from the Solomon Islands capital, Honiara. “She was short of breath,” says her mother, Martha, “so I brought her to the hospital straight away.’’ Florida was admitted to the Pikinini (Children’s) Ward with severe pneumonia and treated with antibiotics. Pneumonia can be deadly for many young children, but thanks to effective treatment, Florida was much better within days.
Luckily for baby Florida, her mother did just the right thing in bringing her to a health facility for treatment. Unfortunately, in Solomon Islands, many people use antibiotics without a prescription from a health worker. “Many people buy antibiotics and take them when they have a headache, a cold or pain,” says Solomon Bosa, Secretary of the country’s Antibiotics Stewardship Committee. “But antibiotics don’t treat these kinds of problems. People need to be aware that they should only take antibiotics when prescribed by a health worker at their clinic or hospital.”
If antibiotics are taken when they are not needed, or if they are not taken correctly, antimicrobial resistance (AMR) can result. AMR happens when microorganisms (such as bacteria, viruses and parasites) change when they are exposed to antimicrobial drugs (such as antibiotics and antimalarial drugs). As a result, the medicines become ineffective. It becomes much harder to cure infections and they spread to others. Antimicrobial resistance is present in all countries, and it is a significant issue in Solomon Islands.
Success in Solomon Islands
In Solomon Islands, the World Health Organization (WHO) has been working with the Ministry of Health and the National Referral Hospital (NRH) to fight AMR. One major achievement was the development of Solomon Islands Antibiotic Guidelines 2015. Before the Guidelines were implemented, only 5% of antibiotic prescriptions at NRH followed best practices. Now that doctors have access to the best information, as well as ongoing training, that number has increased to 58%. “This is a fantastic achievement,” says Mr Bosa. “We have evidence that the Guidelines have made a big difference in correct antibiotic prescriptions. Now we must work to increase this rate even more, and ensure that other health facilities are using the Guidelines consistently.”
A coordinated approach
Antimicrobial resistance is an issue that cuts across multiple sectors and affects all of society. To tackle it, innovative, coordinated action is required.
On a global scale, WHO is working with the Food and Agriculture Organization of the United Nations (FAO) and the World Organisation for Animal Health (OIE) to tackle AMR through a ‘One Health’ approach. This alliance works to avoid the emergence and spread of AMR through promoting best practices, including optimal use of antibiotics in both humans and animals.
In Solomon Islands, WHO is working with the Ministry of Health to conduct a comprehensive situation analysis and a national action plan. “These tools will guide the way forward, so that we can choose the best possible strategies to fight against AMR,” says Dr Sevil Huseynova, WHO Representative in Solomon Islands. “Our committed partnership with the Government means that we have a strong team working together on this important challenge.”
Dr Tenneth Dalipanda, Permanent Secretary to the Solomon Islands Ministry of Health and Medical Services, is confident that the Ministry and its partners are moving in the right direction. “While we still have a long way to go, we have already seen significant improvements in rational prescription of antibiotics. Thanks to the support of WHO, we will continue to implement better planning, training and community education to address the issue of AMR.”
The Pharmacy division of NRH, with support from WHO, is spearheading activities for World Antibiotic Awareness Week, 13–19 November 2017, including workshops for health workers, educational visits to schools, and public information forums. With commitment and hard work, Solomon Islands is determined to tackle AMR so that antibiotics remain effective for patients like baby Florida well into the future.