Antibiotics are the ‘miracle drugs’ of the 20th century. They made possible great progress in turning many
bacterial infections into illnesses rather than death sentences. Along with vaccines, they have transformed
death in infancy and childhood from an ever-present danger into a rare event. Remarkably, Alexander
Fleming, who discovered penicillin, warned of resistance in the 1930s. He made what may have been the
first plea for antibiotic stewardship—use penicillin only when necessary and do not ‘under-dose’.
Unfortunately, the world has used penicillin and the rest of the available antibiotics, developed mainly in the
1940s and 1950s, at an ever-increasing rate, both when they are needed and when they are not, in human
beings and other animals. The result is that today many antibiotics have lost their effectiveness against
common bacterial infections and antibiotic resistance continues to increase in most countries before it has
even been recognized as a major problem.
Antibiotic resistance is no longer a concern for the distant future but is a pressing issue, both globally
and in Tanzania. Data on antibiotic resistance in Tanzania is scarce, but even in the 1990s, resistance to
antibiotics in common use, such as ampicillin, tetracycline and trimethoprim-sulfamethoxazole, was
significant. As part of global effort to preserve the effectiveness of antibiotics, the Global Antibiotic
Resistance Partnership (GARP)-Tanzania aims to develop policy recommendations to govern prudent use
of antibiotics. This situation analysis is a first step, creating a baseline for what is known and identifying the
important information gaps to be addressed in order to create responsible and effective recommendations
for policymakers to consider.
The aim is not to withhold antibiotics when they can save lives and health. Ample evidence—in the form
of infant and child deaths from pneumonia—warns that many people have no access. The aim is to
eliminate as much inappropriate use as possible and increase access where it is inadequate.
Center for Disease Dynamics, Economics & Policy (CDDEP)