By Jeroen Schouten (ESGAP EC member)
MURIA stands for Medicines Utilisation Research in Africa. MURIA grew out of discussions during the World Congress of Pharmacology and Clinical Pharmacology in South Africa in 2014 to progress collaborative drug utilisation research in Africa to enhance the rational use of medicines (RUM). The premise being that countries need drug consumption data before developing pertinent programmes to enhance RUM. This grew out of a similar exercise in Europe in 2008 – the Piperska group. This involves health authority personnel from across Europe and their advisers working and learning together to enhance prescribing efficiency – both new and existing medicines. Collaborative projects/ learnings have included:
- new models to optimise the use of new medicines
- personalised medicine
- quality indicators for new medicines
- risk sharing arrangements
- pharmacovigilance as well as adaptive licensing.
Piperska has also run courses on improving the managed entry of new medicines as well as Interface Management
MURIA first met in Port Elizabeth in January 2015 through Prof. Ilse Truter,- which led to its official formation and an agreed philosophy/ approach: ‘ The MURIA group should be a multidisciplinary network of healthcare professionals striving to promote sustainable, rational medicine use in Africa. This can be achieved through collaborative research and capacity building, with the objective of improving the quality of life of patients, as well as the quality of medicine utilization in Africa’, with the first MURIA symposium planned for July 2015 in the University of Botswana (details on the MURIA website – see here and here-). The meeting was very successful leading to a number of planned activities around key issues. This included anti-microbials.
This resulted in a meeting at the University of Botswana in February 2016 to progress antibiotic research in Africa. Arno Muller from the WHO was a key element of this as we sought to instigate research among private GPs in Botswana on their management of URTIs (suspecting overuse!) as well as instigate a PPS study in both private and public hospitals. The PPS pilot in Botswana (under the endorsement of the Ministry of Health) was presented at the second MURIA meeting resulting in refining of the data collection forms (attached), and we are just starting the URTI study. Pilot and full PPS studies are now ongoing in a number of African countries.
There were with many other presentations and discussions relating to antimicrobials in Botswana in July 2016 (details of the abstracts presented already on the website as well as the workshop materials can be accessed here). We also have a number of papers published and submitted (attached) as well as in various stages of submission with many more planned. Overall over 120 people from over 10 African countries came to Botswana in July – with very good feedback. This will help progress MURIA in the future.
We finished the Wednesday morning session in Botswana by discussing the next steps for MURIA including holding the third meeting in Namibia in 2017. Anti-infectives – especially antibiotics – will again be a key theme. This builds on PPS studies planned/ ongoing in a number of African countries – building on the experiences in Botswana.
MURIA and ESGAP have pledged to collaborate around effective policies to enhance the rational use of antibiotics in Africa with its many challenges if interested The collaboration will focus on the following subjects:
- Exchange of information on best practices; present and past surveys; and on educational courses that are provided by both MURIA and ESGAP around rational use of antibiotics
- Try to co-design “teach the teacher” courses on antibiotic stewardship in low resource countries intentionally together with WHO Europe and WHO Africa
- Provide a window on European (university) research opportunities on ABS in low resource countries
Membership of MURIA is free – forms can be found on the website. The only provision is that new members are interested in collaborative DU research in Africa and that they are currently not an employee of pharmaceutical companies.