Utrecht/WHO Collaborating Centre for

Pharmaceutical Policy and Regulation

November 13th, 2018

WHO Cross-programmatic consultation in Almaty

The WHO European Centre for Primary Health Care, WHO/Europe’s Health Technologies and Pharmaceuticals Programme and WHO Headquarters’ patient safety and risk management unit organised a cross-programmatic consultation for all members of the Antimicrobial Medicines Consumption (AMC) network. This is a network of non-European Union countries in the WHO European Region focussing on curbing antimicrobial resistance (AMR). The meeting took place at the Kazakh National Medical University in Almaty (30 Oct – 1 Nov 2018). It aimed to bring together specialists in the field of AMR policy and relevant stakeholders from the AMC network to discuss the role of primary health care (PHC) in responsible use of antimicrobials and curbing AMR. All participants worked together on how to improve PHC to stimulate responsible use of antibiotics and drafted country roadmaps for reducing over-the-counter (OTC) sales of antibiotics.

On behalf of the WHO Collaborating Centre for Pharmaceutical Policy and Regulation, Aukje Mantel and Tom Jacobs attended the consultation. They presented a literature review about law enforcement activities prohibiting the OTC sales of antibiotics and engaged in panel discussions to reflect on initiatives on a country level and discuss future steps to be taken. It was a fruitful meeting during where many promising plans were presented and obstacles in implementing these plans were openly discussed. Participants raised and discussed the following important topics:

  1. A multifaceted approach is necessary when moving towards prescription only dispensing of antibiotics.
  2. Involvement of pharmacists and other stakeholders in designing law enforcement activities prohibiting the OTC sales of antibiotics is needed.
  3. Implying penalties in case of non-compliance to regulation regarding responsible antibiotic use might not be the most effective measure to reduce OTC sales of antibiotics. In the transition phase of the health system, it could be more effective to let governmental inspectors educate the health care workers about responsible use of antibiotics and the new regulation and create positive incentives to stimulate pharmacists not to sell antibiotics OTC / doctors not to prescribe an antibiotic if not applicable.
  4. Enforcing the law prohibiting OTC sales of antibiotics could potentially lead to unintended effects. Especially the balance between excess of antibiotic use and access to antibiotics should be ensured.
  5. E-prescribing and national clinical guidelines written by local experts can help improve antibiotic prescribing practices in primary health care.