Empowering Action Against a Silent Health Threat

Authored by Anna Erlandson, Communications Specialist, USAID Emerging Threats Division, Global Health Security Program

The medicines used to treat common bacterial, viral and fungal infections around the world are losing their effectiveness — and it’s a deadly problem. Antimicrobial resistance continues to grow as one of the biggest threats to our global health security.  

One study attributes 1.27 million deaths in 2019 to bacterial antimicrobial resistance — to put that toll into perspective, that’s just shy of the population of Dallas, Texas. 

Resistance to the tried and true drugs of the past is alarming, but a coordinated multi-tiered response can improve patient outcomes, avoid infections, and ultimately limit antimicrobial resistance on a global scale. Effective infection prevention and control (IPC) in healthcare facilities is one of the best ways to prevent antimicrobial resistance — by preventing infections from occuring in the first place, and by preventing the spread of antimicrobial resistant bacteria if and when they do occur. 

Although antimicrobial resistance is a global problem, efforts at local health clinics and hospitals can have cascading beneficial impacts. In Kenya’s Kilifi County, three women are making a difference in their community through Antimicrobial Stewardship, a program that promotes the appropriate use of antimicrobial medicines.

Improving infection prevention and control is one of five objectives in the World Health Organization’s Global Action Plan on Antimicrobial Resistance. Foundational to proper infection prevention and control is access to and use of improved water, sanitation and hand-washing facilities, in addition to proper waste management and environmental cleaning. This evidence-based approach to preventing avoidable infections involves everyone in the health care system, from policymakers to frontline health workers, and is relevant to every patient interaction and level of care. 

Leading Facility Infection Prevention and Control

Nurse Priscillah Makazi leads infection prevention and control at the Kilifi County Referral Hospital. In addition to her role as head nurse of the neonatal unit, she has conducted over 85 training sessions on infection prevention and control over the last five years. 

She teaches others how to reduce antimicrobial resistance by limiting the opportunity for infections to grow, become resistant to drugs, and spread person-to-person. 

“I find my job meaningful because infection prevention to ensure safety is very critical in any health care setting,” she said.

In 2021, when USAID’s Medicines, Technologies and Pharmaceutical Services (MTaPS) project began working in Kilifi County Referral Hospital, Priscillah noticed a difference in infection prevention and control activities. 

“MTaPS came to our rescue and since 2021, we’ve moved miles on infection prevention standards implementation, from the training and support in the operating procedures and job aids, to supportive supervision and better quality assessment and mentorship,” she said.

Leading County Infection Prevention Control Across Hospitals

Florence Lughage is the Kilifi County IPC Coordinator. For the past six years, she has been leading coordination efforts across county hospitals to train staff and oversee IPC activities.

“I find my job very meaningful because it adds to improving the quality of care in healthcare…we are able to make sure there is compliance with all infection prevention control activities, for example hand hygiene compliance and healthcare waste compliance. From baseline, we have made a very tremendous improvement of 70%, so that is something to be very proud of. …we are able to reduce hospital acquired infections.” 

Florence has received training through USAID’s MTaPS program in Kenya. 

Leadership in Coordination and Information Sharing

Dr. Aisha Mongi is a clinical pharmacist and leads Antimicrobial Stewardship efforts for Kilifi county. She coordinates networking and information sharing between three healthcare facilities, including Kilifi County Referral Hospital, where Florence and Priscillah work.

In 2023, Aisha worked with Florence and Priscillah to conduct pre-training surveys to determine a baseline knowledge of AMR and IPC among healthcare workers in the county. This heavily influenced the content of training materials, in which she was able to consolidate county-level data and share it on a national level to inform AMR guidance throughout Kenya. 

“The biggest [successes] I’ve seen is doing surveys and studies with our own data so we know where we are at and use the data in order to make interventions and informed decisions.”

Although the campaign against AMR is global, much of the work that makes a difference is done on the community level. Together, Priscillah, Florence and Aisha are leading the fight against AMR in Kilifi County, and their influence is reaching beyond their community and influencing national action plans in the fight against AMR.