In June 2024, a 66-year-old woman was admitted to the Medical Intensive Care Unit at Intermediate Hospital Katutura in Windhoek, Namibia. She was diagnosed with pneumonia, and tests showed that the organism responsible for her severe illness was resistant to all antibiotics except tigecycline. At the hospital, the pharmacy department had to obtain a compassionate clearance permit to procure and import tigecycline for the patient.
“The patient completed the course, stabilized, and was discharged from the intensive care unit to a general ward. Unfortunately, due to various complicated comorbidities, the patient eventually passed away”, said Ms Taimi Ipinge, a Chief Pharmacist at Intermediate Hospital Katutura.
Tragically, this type of resistance to antibiotics is all too common in Namibia, as with elsewhere in the world.
Antimicrobial resistance (AMR) occurs when bacteria, viruses, fungi, and parasites change over time and no longer respond to medicines, making infections harder to treat and increasing the risk of disease spread, severe illness, and death. As a result, the medicines become ineffective and infections persist in the body, increasing the risk of spread to others.
AMR is one of the top global public health and development threats. It is estimated that bacterial AMR was directly responsible for 1.27 million global deaths in 2019 and contributed to 4.95 million deaths.
In 2019, Namibia recorded 451 deaths attributable to AMR and 1,900 deaths were associated with AMR.
Acting to stop AMR
The Government of Namibia recognizes that AMR is a threat to health security across the country and region and that a range of health system interventions are necessary to protect the population’s health and ensure good progress towards universal health coverage (UHC).
The Ministry of Health and Social Services (MoHSS), with support from WHO through the UHC Partnership and others, is implementing various activities in line with the AMR National Action Plan in compliance with the Global Action Plan to address AMR.
The Government responded to the overuse of antibiotics by setting up a national multi-sectoral AMR governance to guide, oversee, coordinate, and monitor AMR-related activities in all sectors to ensure a systematic and comprehensive implementation of Namibia’s National Action Plan on AMR.
In November 2021, Namibia commemorated its first World Antimicrobial Awareness Week (WAAW). In 2023, MoHSS in collaboration with AMR quadripartite organizations, commemorated the week under the theme of ‘Preventing antimicrobial resistance together’ with the slogan ‘Antimicrobials: handle with care’. The event brought together the Ministry of Health and Social Services, the Ministry of Agriculture, Water and Land Reform, and the Ministry of Environment, Forestry and Tourism.
Namibia launched its infection prevention and control action plan and national guidelines. WHO provided support to a range of activities for this including distribution of information, education and communication materials around infection prevention and control, regional orientation on quality standards, in-service training focal points, and training on water, sanitation, and hygiene for hospital quality improvement plans. Thanks to capacity-building support from WHO, Namibia also reached a significant milestone for the first submission of data on AMR to GLASS in December 2023.
“AMR is extremely serious. If left unchecked it means we are heading to a world where medical treatment of routine ailments or operations is life threatening and a greater number of people might stop responding to drugs. It challenges all our efforts to strengthen health systems and achieve universal health coverage. WHO commends the Namibian Government for the strategic and multiple approaches taken through collaboration between sectors and work across the region to raise awareness amongst the public,” said Dr Richard Banda, WHO Representative to Namibia.
Strengthening health security
Namibia’s response to antimicrobial resistance (AMR) is part of the broader effort to strengthen health security across the country. By integrating a One Health approach and engaging key sectors, Namibia is actively working to strengthen its health systems, improve surveillance, and ensure that it is prepared to respond to emerging health threats. The launch of the National Tripartite One Health Strategy 2024-2028 further underlines the government’s commitment to safeguarding public health, both within the country and in collaboration with regional and international partners.
The UHC Partnership operates in over 125 countries, representing over 3 billion people. It is supported and funded by Belgium, Canada, the European Union, France, Germany, Ireland, Luxembourg, Japan, the United Kingdom of Great Britain and Northern Ireland, and WHO.