To combat antimicrobial resistance (AMR), which is making it harder to treat infections effectively, reliable data on antimicrobial consumption (AMC) is crucial. But obtaining accurate AMC data can be challenging since data sources often only provide aggregated estimates, without specific patient information or reasons for antimicrobial usage. While dispensing data from healthcare facilities can offer valuable insights into actual patient use, data collection from these facilities is often resource-intensive and complex.
In Indonesia, efforts have been made to study antimicrobial consumption using the Anatomical Therapeutic Chemical (ATC) classification system and the Defined Daily Dose (DDD) methodology. Nonetheless, consolidating AMC data in Indonesia is challenging due to its scattered nature across different systems and platforms. The lack of clear mapping further complicates the manual combination of data from sources such as e-monitoring and evaluation (e-monev) and pharmacy units in healthcare facilities. Therefore, it is imperative for Indonesia to assess and map potential data resources to establish a robust AMC surveillance system in the country.
As part of the collaboration to establish such a system, WHO assists the Ministry of Health (MoH) in assessing potential data resources for AMC surveillance and enhancing the capacity of stakeholders. The AMC data assessment and training was conducted from 22-26 May 2023.
The AMC data assessment involved key stakeholders from the MoH, National Agency of Drug and Food Control (BPOM), Healthcare and Social Security Agency (BPJS Kesehatan), and private sector to identify all distribution, manufacturing, and import data. During the assessment, WHO assisted the MoH to select data to be used in national AMC surveillance and submitted to GLASS AMC.
The activities continued with AMC training. WHO trained the technical 62 staff from the stakeholders in this hybrid training, which resulted in better understanding on available data for AMC and steps for establishing national AMC monitoring system.
“The AMC data assessment and training is critical to improve the quantity and the quality of antimicrobial consumption in Indonesia. This is in line with Indonesia’s AMR national action plan 2021-2024 and MoH’s six pillars of health transformation,” said Dr Agusdini Banun S, Director of Pharmaceutical Services and Management of the MoH, in her opening remark.
Antimicrobial consumption training for related stakeholders at Bogor, 24-26 May 2023. Credit: WHO/Mikyal Faralina
The monitoring of AMC plays a crucial role in providing valuable insights for developing strategies to utilize antimicrobials optimally. By assessing AMC data, we can gather information about the accessibility and affordability of antimicrobial agents. When combined with other relevant data, such as AMR data, AMC data can inform the development of clinical guidelines, protocols, and restrictions on using specific agents for certain clinical conditions or designated prescribers. These measures are essential to ensure appropriate and optimal use of antimicrobials. Building the capacity of data providers to collect and report consumption data is crucial for establishing a reliable data collection process.
To follow it up, Indonesia aims to establish national AMC surveillance this year and submit its first AMC report to the GLASS in the 2023 data call. Meanwhile, AMC will be monitored through regular data from BPOM. These concerted efforts in curbing antimicrobial resistance will help to save millions of lives in the future.
The Kingdom of Saudi Arabia generously supports the AMR activities of WHO Indonesia.
Written by Nora Nindi Arista, National Professional Officer for Antimicrobial Resistance, WHO Indonesia.