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Home  »   Insight   »   How the Medicines to Ukraine campaign became an effort to also help reduce Anti-microbial Resistance

How the Medicines to Ukraine campaign became an effort to also help reduce Anti-microbial Resistance

An individual is injured on the frontline in Ukraine, and they reach over to their emergency packs which contain pain relief such as morphine, and medical tools. They are then given primary care by either the police, or military and triaged to evacuation hubs. The infection risk is unknown, the chances of having an infected wound at this point is unlikely. Moreover, as this individual is transferred between the different points of care, the cleanliness of transport vehicles and hubs are also unknown.

Wed 21st December 2022 The PDA

What happens next?

Once at one of the very many near front-line evacuation hubs, there are no facilities for microbiology testing and the patient will be given broad-spectrum antibiotics. Due to the nature of war, this is a rushed process, the patient is then transferred to a central and larger hospital that is further away from the front line with no clear clinical history or idea of what antibiotics have been used thus far in their treatment or previously.

At this point, they are clinically assessed for signs of infection and given further courses of antibiotics as their blood samples are finally sent to microbiology for screening. However, with sample turnaround taking a minimum of seven days in Ukraine due to the effects of the war and no facilities to isolate patients in the meantime, what does this mean? If this patient suffers from multiple organ failure, their chances of survival are significantly reduced. If their organs do not begin to fail, then they are loaded with combinations of broad-spectrum and strong antibiotics. But still, what does this mean long-term, and for the rest of Ukraine there is already a consequential increase in the incidence of antimicrobial resistance (AMR).

Antimicrobial resistance has been a global issue for decades as highlighted in published research, and it continues to be an increasing concern for our health.

For the individual injured on the frontline, it means that if they experience another episode of infection, there are not many options for treatment. It also means the rate of AMR is rapidly increasing in the rest of Ukraine, as patients with multiple resistance are transported across the country and microbiology falls behind. There have been reports of this problem spreading across the European continent as casualties are being moved to other countries for ongoing treatment and rehabilitation and antimicrobial resistance moves with them. This matter requires urgent attention.

Where the Medicines to Ukraine campaign started off helping a war-torn country with a lack of resources and lack of essential medicines to treat casualties, it is now looking at strategic assistance in this growing area of concern. The PDA has been contacted by the Ukrainian Ministry of Health and were asked for assistance with the emerging AMR crisis that is now gripping the country.

The consignments of much-needed medicines continue to be sent with contributions collected from supporters across Europe and beyond, but alongside this, the campaign has also been asked to provide appropriate disinfectants and cleaning equipment to support infection control. On a wider collaborative and educational point, in collaboration with the British Society of Antimicrobial Chemotherapy (BSAC), policies, protocols, and strategies are being produced for the local level hospitals in Ukraine to help to address the levels of antimicrobial resistance clinicians are facing on the frontline. As a pan-European movement, Medicines to Ukraine is now also supporting the development of strategies to address the wider issue of AMR in Ukraine that is slowly spreading across Europe.

You can read more about the work we have conducted for Ukraine here.

By Tasnim Khan, PDA Policy Officer

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