Communication, Information and Knowledge Exchange in the Prevention of Antimicrobial Resistance in South Africa and Worldwide: A Narrative Bioethical Review
Bioethics, communicative ecology and AMR  

Current study uses the method of narrative review and the method of bioethical analysis to evaluate the status of management antimicrobial resistance in South Africa and globally. Specific focus is placed on the evaluation of the alignment of the strategic, operational and tactical decision-making between international, regional national and sub-national level of planning decision-making, data and information exchange, and mechanisms to minimise human suffering due to antimicrobial resistance. Antimicrobial resistance is looked at as a feedback loop which results from the irrational prescribing an overuse of antimicrobial medicines by humanity, and through the lens of the utilitarian qubit. Results of the study indicate that the World Health Organisation and other international, or regional organisations stimulate collaboration and create/operationalise platforms that allow for efficient exchange of information about antimicrobial resistance. Limitations exist in the antimicrobial resistance testing and linking of prescribing and dispensing of antimicrobial agents in low- and middle-income countries. Solutions are proposed to address the gaps at the tactical level of decision-making and to deal with uncertainty antimicrobial resistance development in the future. These include of targeted training mechanisms, which are legislated at the national level of government, and which empower frontline healthcare workers. These training programmes should be supplemented by the use communicative ecology in data gathering, and information sharing. It is also important to drive behavioural rigor in prescribing, dispensing, and therapeutic uses of antimicrobial medicines in public healthcare systems. Finally, health literacy of all stakeholders should be continuously monitored in relation to antimicrobial resistance.

utilitarian qubit; health threats; tactical decision-making; training; frontline healthcare workers

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