The First Therapeutics Committees Implemented in Mali

Inappropriate management and use of medicines and pharmaceutical products are challenges that health facilities in Mali face regularly. Misuse and weak health systems can compromise the safety of medicines, promote wasting resources, and lead to the rise of antimicrobial resistance (AMR). WHO’s Joint External Evaluation (JEE) of the International Health Regulations, conducted in June 2017, revealed Mali’s limited capacity for antimicrobial stewardship (AMS), with a score of 1 out of 5.

As indicated by Dr. Sirantou Tata Dena, doctor and focal point for AMR at the Centre de Santé de Référence in Koutiala, “I was a focal point for AMS in my previous unit and I had a lot of difficulties to make my colleagues understand the importance of AMR.”

Therapeutics committees are a proven way to reduce inappropriate practices and to promote sound management of medicines among health care professionals. A therapeutics committee provides a forum for improving health care delivery by reviewing good prescribing and dispensing practices and implementing improvement strategies for medicine use in health facilities. The USAID Medicines, Technologies, and Pharmaceutical Services (MTaPS) program is supporting Mali’s Ministry of Health in implementing the country’s first-ever therapeutics committees. These committees have been implemented in five hospitals as sentinel sites to provide an assessment before extending them to other health facilities.

During the trainings provided at the end of October 2020, facilitators focused on the AWaRe (access, watch, reserve) classification and functioning of the committees. The Direction de la Pharmacie et du Médicaments and MTaPS provided technical support for the start of these activities: MTaPS has supported the country since June 2020 to develop terms of reference for committees and training modules for its members. During this first phase, 56 practitioners, including 12 women, were trained.

The implementation of the committees will help Mali improve its score during the next JEE. Next steps before a full extension include support for better functioning of the committees that will be achieved through supervisory activities and additional trainings, including the use of an e-learning platform. Next steps also include extending the implementation of committees to 11 other health facilities in Mali.

Dr. Tata Dena indicated that “the training was very interesting and was a change from trainings received before. The method of the assessment of core indicators helps identify the full scope of activities to be addressed by the group managing antimicrobials [a unit within the therapeutics committees] by noting weaknesses, such as a lack of respect of protocols and prescribing practices.”