Medical professionals and the Rwanda Biomedical Centre (RBC) have raised alarm over the misuse of drugs, warning that such practices are contributing to the growing challenge of antimicrobial resistance (AMR).
Misusing antibiotics, including using them unnecessarily or failing to complete a prescribed course, can lead to AMR, where germs develop the ability to withstand the drugs intended to eliminate them.
This resistance renders infections harder or even impossible to treat.
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Antimicrobial resistance occurs when microorganisms such as bacteria, viruses, fungi, and parasites evolve to resist medications—including antibiotics, antivirals, antifungals, and antiparasitics—that were once effective.
This phenomenon is a major public health concern globally, as it complicates treatment, prolongs infections, and increases the risk of severe complications and death.
RBC, in partnership with the Infection Prevention and Control Rwanda Organisation (IPCR), hospitals, and international pharmaceutical company Pfizer, is implementing measures to combat AMR.
These efforts include raising awareness about the risks of drug misuse and advocating for improved medical practices.
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Dr. Leopold Bitunguhari, a medical researcher at the University Teaching Hospital of Kigali (CHUK), emphasised that improper use of medicines undermines their effectiveness.
"If patients do not follow medical advice or are given drugs that do not match the disease, the treatment fails,” he explained.
For example, amoxicillin, a commonly used antibiotic, is reportedly ineffective in 80% of cases due to misuse. This penicillin-based antibiotic is used to treat bacterial infections such as tonsillitis, bronchitis, and pneumonia.
Dr. Bitunguhari called for the development of updated drug formulations and urged healthcare professionals to enhance prescription practices. He also stressed the need for pharmacists to adhere strictly to ethical standards, avoiding the sale of unprescribed medications.
For Rwanda, like many low- and middle-income countries, the burden is exacerbated by resource limitations, gaps in antimicrobial stewardship, and the misuse of antimicrobials across various sectors. We believe in the power of evidence-based practices, multisectoral collaboration, and proactive health measures. We explore strategies to strengthen antimicrobial stewardship, enhance infection prevention, and ultimately safeguard the efficacy of life-saving treatments for future generations," added Jean Jacques Irakiza founder of Infection Prevention and Control Rwanda Organization (IPCRO).
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The improper disposal of medicines and the use of antibiotics in livestock and agriculture also contribute significantly to AMR. These practices allow resistant bacteria to spread to humans through food or environmental contamination.
Hospitals—through overuse of antibiotics, inadequate hygiene practices, and unsterilized equipment—are also hotspots for the spread of resistant microorganisms.
"Promoting research on AMR and preventive measures such as regular handwashing in schools, markets, and public spaces is crucial,” Dr. Bitunguhari noted.
"Without effective treatment options, drug-resistant infections can lead to severe outcomes or death.”
According to Claude Mambo Muvunyi, RBC’s Director General, antimicrobial resistance accounts for at least 1.27 million deaths annually worldwide. "New evidence shows AMR surpasses HIV/AIDS and malaria as a leading cause of death,” he said.
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Infections caused by resistant microbes often result in prolonged hospital stays, increased healthcare costs, and more intensive care. Muvunyi highlighted the critical need to act against AMR to safeguard the future of medicine.
"Every action we take today shapes the future of medicine. Let’s raise awareness and protect antibiotics for generations to come,” he urged.
Pharmacies under scrutiny
Pharmacies have come under scrutiny for contributing to drug misuse and AMR.
Some pharmacies sell antibiotics without prescriptions, fail to verify the appropriateness of prescriptions, or provide insufficient guidance on proper drug use.
These practices enable the misuse and overuse of antibiotics, exacerbating resistance.
Jean Claude Mutabazi, a pharmacist, called for stricter adherence to ethical practices.
"Pharmacists must ensure that medicines are used as prescribed. Patients should take drugs as recommended to avoid resistance,” he said.
Inadequate regulation of pharmacies can also lead to the sale of counterfeit, substandard, or expired medications, posing additional health risks.
Rwanda has launched the Antimicrobial Resistance National Action Plan 2.0, a strategic framework to address AMR. The plan outlines interventions for the government and partners to tackle this global health threat collaboratively.
Over 60% of human infections are zoonotic, originating from animals. Misuse of antimicrobials in livestock fosters resistance that can transfer to humans. The plan aims to address these challenges by promoting responsible use of antimicrobials across sectors.
Medical experts emphasise the importance of seeking treatment only at certified health facilities to ensure appropriate medication use. They also advocate for better disposal of unused drugs and the enforcement of regulations to curb malpractice in pharmacies.