The Ombudsman’s Office asked the Ministry of Health to take concrete and coordinated actions to reduce the problem of misuse of medicines, which leads to increasing resistance to antimicrobials.
This followed the investigation of a complaint from a person concerned because in Costa Rica concrete actions to address the problem of antimicrobial resistance are scarce, disjointed, and do not respond to a national strategic plan.
Given this, the Ombudsman asked the ministry to do what is necessary to strengthen regulatory measures to reduce and mitigate the effects of misuse of antibiotics, antivirals, antiparasitics and antibiotics in human and animal health, as well as in agricultural use.
In order to verify the actions implemented, she requested reports from The Ministry of Health, the Ministry of Environment and Energy, the Association of Pharmacists, Agronomists, Physicians and Surgeons, Microbiologists and Clinical Chemists, Veterinary Doctors, Ministry of Economy, Industry and Commerce, the CCSS, the National University, University of Costa Rica and the National Technical University. She was looking for the institutional measures taken to address the problem.
These were the findings:
• Although Costa Rica was one of the countries that approved the Plan of Action on Antimicrobial Resistance at the session of the WHO Regional Committee for the Americas in 2015, it is still under construction.
• There is disarticulation in the policies of correct use of antibiotics among the different responsible institutions.
• There are hardly any “voluntary” programs initiated by some actors to optimize the use of antibiotics, but not in a planned, regulated and supervised manner by the Ministry of Health.
• It is necessary to strengthen controls for the sale of antibiotics because medical prescription is inefficient.
• The prescription of drugs must be done in strict adherence to good practices. In some cases this prescription is made by non-specialist doctors.
• The country has been one of the pioneering countries in the Region in including antimicrobial resistance as a mandatory notification event; regulations are pending, so it is necessary to strengthen them.
Some of the recommendations given by the Ombudsman to the health authorities, is to form an inter-institutional commission to establish the formulation of the National Action Plan on Resistance to Antimicrobials, make a review of the national legislation and formulation of new laws or amendments to current regulations, and formulate proposals to strengthen surveillance and institutional research actions, among others.