Reforming pre-service curriculum as a sustainable low-cost intervention to address antimicrobial resistance

Antimicrobial resistance (AMR) is an extremely serious public health problem, and requires urgent and concerted actions. Management Sciences for Health's USAID-supported Strengthening Pharmaceutical Systems Program (SPS) and its predecessor—RPM Plus—collaborated with in-country stakeholders in Zambia to jump-start a country-level AMR advocacy and containment initiative. The effort led to the formation of a local AMR advocacy working group that built strategic coalitions with other local players to generate public awareness about AMR, revise national standard treatment guidelines, improve the regulatory authority's antimicrobial quality control activities, and reform pre-service curriculum used to train health professionals. To address curriculum reform, RPM Plus and SPS collaborated with the advocacy working group to provide technical assistance to University of Zambia stakeholders to conduct curricular gap analysis, disseminate findings, and identify relevant AMR and rational medicine use (RMU) topics to fill gaps. University stakeholders embraced all the AMR and RMU-related topic recommendations as relevant competencies for today's undergraduate level medical graduates in Zambia and included them in the finalized new version of the curriculum. The 2001 WHO Global Strategy for Containment of Antimicrobial Resistance and the 2004 International Conference on Improving Use of Medicines identify pre-service curricular reform as a key intervention. In this context, Zambia's successful example serves as a model that other resource-constrained countries can utilize to implement pre-service curricular reform as a sustainable, low-cost intervention to address the growing and serious public health threat posed by AMR.