Mali is a member of the Global Health Security Agenda (GHSA), which is a partnership of countries and organizations that aim to make the world safe from infectious disease threats by raising global, regional, and country capacity to prevent, detect, and respond to infectious disease threats. MTaPS’ technical assistance in support of this agenda focuses on helping the country to slow the emergence of antimicrobial resistance (AMR) by strengthening systems and practices for infection prevention and control (IPC) and optimal use of antimicrobial medicines, including fostering and strengthening antimicrobial stewardship (AMS).
The program’s activities include helping to build the capacity of the national multisectoral coordination committee (GCMN-RAM) and key in-country stakeholders and health facility staff to implement the 2019–2023 national action plan for AMR (NAP-AMR) and progress toward the next levels in terms of Mali’s Joint External Evaluation capacities in IPC and AMS.
Strengthening multisectoral coordination on AMR
MTaPS supports the GCMN-RAM in convening quarterly meetings to review the implementation of the NAP-AMR. MTaPS is also working with the GCMN-RAM IPC and AMS technical working groups to identify roles and responsibilities and establish lines of reporting and accountability between the GCMN-RAM and the One Health Platform. Establishing communication channels between these groups creates a forum for promoting policies and advocating for legislation for AMR containment and antimicrobial use and an opportunity for shared learning across sectors.
Strengthening IPC programming
MTaPS IPC activities, which cover both the human and animal health sectors, support the efforts of the government and other stakeholders to lay a foundation for establishing a national IPC program from the central to the peripheral level. In the animal sector, MTaPS is working with the GCMN-RAM, Ministry of Livestock and Fisheries, Directorate of Veterinary Services (DNSV), and other implementing partners to develop national guidelines for IPC in animal health care settings based on the international code of infection prevention with respect to general food hygiene principles. In the human health sector, MTaPS is working with the GCMN-RAM, the World Health Organization (WHO), and the Ministry of Health and Social Affairs to develop a national toolkit to help health facilities, local nongovernmental organizations, community health workers, and local media disseminate and implement Mali’s IPC guidelines.
In collaboration with the General Directorate of Health and Public Hygiene and the GCMN-RAM, MTaPS is working to build a pool of IPC champions to lead the implementation of IPC guidelines and train other health care professionals in selected facilities. Through mentoring and coaching, MTaPS is strengthening the capacity of the GCMN-RAM to assist IPC committees at health facilities in implementing these guidelines.
Optimizing the use of medicines and strengthening AMS
Drafting a national AMS strategy
MTaPS is providing technical support to the Directorate of Pharmacy and Medicines (DPM), DNSV, and GCMN-RAM to draft a national AMS action plan that includes interventions to strengthen AMS in both the human and animal sectors. This includes guidelines on procuring, distributing, prescribing, and dispensing antimicrobials. In addition, MTaPS is assisting the GCMN-RAM and partners to develop national guidelines for the use of antimicrobials in the human health sector.
Developing treatment guidelines to manage common infectious diseases
To improve the rational use of antimicrobials, MTaPS is working with the GCMN-RAM, DPM, and infectious disease experts to revise the infectious disease component of the national standard treatment guidelines. MTaPS is also supporting national stakeholders to draft standard tools to monitor compliance with the country’s rational antimicrobial prescribing practices.
Integrating AWaRe classification into the EML
The 2017 WHO model essential medicines list (EML) was revised to categorize antibiotics on the list into three classes—Access, Watch, and Reserve (AWaRe)—and specific recommendations were made on when each should be used. MTaPS will use the opportunity of the next revision of the EML in Mali to support the GCMN-RAM and DPM to incorporate this classification.
Strengthening Drug and Therapeutics Committees
MTaPS is supporting the GCMN-RAM and the National Agency for Hospital Assessment to assist selected health facilities to establish and strengthen Drug and Therapeutics Committees (DTCs) and use them as a platform to promote, implement, and monitor AMS. The intervention includes competency-based training and capacity building of DTCs in monitoring prescription and dispensing practices at the facility level and implementing continuous quality improvement approaches to change behaviors and improve adherence to guidelines.