Utilizing data on antimicrobial use and knowledge to inform regulatory changes to antibiotic packaging and support antimicrobial stewardship efforts in Bangladesh

Overview

Bangladesh has been committed to tackling antimicrobial resistance (AMR) since 2017, with the development of the first National Action Plan for AMR Containment 2017-2022, followed recently by the second iteration for the period 2023-2028. Over the past years, key priorities have included initiatives to raise awareness about AMR and establish surveillance systems to monitor antimicrobial resistance and usage patterns within the human health sector. Antimicrobial stewardship efforts undertaken to date include the development of national treatment guidelines and the piloting of selected interventions in a small number of hospitals. The Directorate General of Drug Administration (DGDA), operating under the Ministry of Health & Family Welfare, serves as the national regulatory authority tasked with ensuring the quality, safety, and efficacy of pharmaceutical products through the enforcement of relevant legislation. Enforcing the regulations to prohibit over-the-counter sale of prescription-only medicines, including antibiotics, has been challenging due to the 86 local manufacturers producing 98% of medicines for the pharmaceutical market and the vast number of pharmacies in the country (approximately 202,500 in 2022), leading to a large proportion of antibiotics being obtained over the counter and self-medication with antibiotics. Compounding this issue is a lack of understanding about antibiotics and AMR among the general population. This lack of awareness further perpetuates inappropriate antibiotic usage in Bangladesh.