AMR ibaho igihe agakoko kihinduranyije kakagira ubushobozi bwo kudahangarwa n’umuti wagenewe kukica, ibituma kuvura indwara kateje bigorana cyangwa bikaba bidashoboka, uyifite ikaba yamuhitana.

Biterwa n’impamvu zitandukanye cyane cyane iyo imiti ya ‘antibiotique’ ikoreshejwe nabi, udukoko tugira ubudahangarwa, bigatuma indwara igorana kuvurwa ibishobora no gutera n’urupfu.

Ni ikibazo gihangayikishije Isi cyane n’u Rwanda rudasigaye.

Nko mu 2021, abantu bagera kuri miliyoni eshanu bishwe n’indwara zatewe n’udukoko twihinduranyije muri ubu buryo. Bisobanuye ko abo bantu batari gupfa iyo izo ziba zashobora kuvurwa.

Byitezwe ko abaturage miliyoni 30 bashobora kuzaba bicwa n’iki kibazo hagati ya 2025 na 2050 mu gihe nta kintu cyaba gikozwe.

Miliyari 40 Frw zateguriwe kurwanya AMR mu Rwanda

Kuko u Rwanda rutari akarwa, na rwo rukomeje kugirwaho ingaruka na AMR kuko imibare igaragaza ko abarenga ibihumbi 17 bahitanywe n’iki kibazo mu Rwanda mu 2019 no mu 2021.

Ni byo byatumye rushyira hanze gahunda y’imyaka ine kugeza mu 2029 yo guhangana n’iki kibazo mu guharanira ubuzima bwiza bw’abantu n’amatungo hagamijwe kugera ku ntego y’iterambere rirambye.

Izibanda ku gukemura ibibazo bijyanye n’utwo dukoko, aho hibandwa ku ngamba zirimo kunoza isuku, gukoresha neza imiti no gukora ubukangurambaga mu baturage.

Birushijeho muri iryo genemigambi, hazatangwa amahugurwa ku baganga bandika imiti, abakora muri za ‘pharmacie’ bayitanga n’abaturage bagasabwa gufata neza imiti bandikiwe, kuko kimwe mu bizamura ubudahangarwa bw’udukoko ari ukudakurikiza amabwiriza ya muganga.

Ni gahunda izashyirwa mu bikorwa hisunzwe inzego zitandukanye ziyobowe n’Ikigo cy’Igihugu gishinzwe Ubuzima (RBC) n’abandi bafatanyabikorwa hagamijwe kurwanya iki kibazo.

Muri iyi myaka, hazifashishwa ingengo y’imari ya miliyoni 29,6$ (arenga miliyari 43 Frw).

Ni amafaranga azahabwa ibigo bitandukanye bizashyira mu bikorwa iyi gahunda. Nka RBC izakoresha 36,1% by’aya mafaranga, bingana n’arenga miliyari 14,5 Frw, Ikigo cy’Igihugu gishinzwe guteza imbere ubuhinzi n’ubworozi cyiharire 35,7% na yo arenga miliyari 14,3 Frw.

Aya mafaranga kandi azahabwa ‘One Health Secretariat’ mu guhuza inzego zitandukanye mu kwita ku buzima.

Ikibazo cy’udukoko tugira ubudahangarwa ku miti gikomeje guhitana benshi

Mu ngengo y’imari, iyi gahunda izatwara 10,7% agera kuri miliyari 5 Frw, Kaminuza y’u Rwanda na yo izahabwa angana uko na ho Ikigo cy’Igihugu cyita ku Bidukikije kizahabwa 6,2%.

Ubukangurambaga muri iyi gahunda bwagenewe miliyari 6,3 Frw azafasha mu gutera inkunga gahunda z’uburezi kuri iki kibazo, ubukangurambaga mu baturage gutanga ibikoresho byo kurwanya AMR mu mashuri, ibigo by’ubuvuzi, imiryango n’abandi.

Muri iyi gahunda kandi hazibandwa ku bijyanye no kugenzura inzira zitiza umurindi AMR, bizatwara miliyari 14,3 Frw. Ni amafaranga azafasha mu kwagura za laboratwari zipimirwamo utu dukoko, gushyiramo ibikoresho byifashishwa n’ibindi.

Hazakoreshwa kandi miliyari 16 Frw mu bikorwa byo kugabanya ibyatuma abantu bandura nko gushyiraho uburyo bwo kwimakaza isuku n’isukura, uburyo bwo kwirinda udukoko n’ibindi bifasha abantu n’amatungo kwirinda udukoko mu buryo bushoboka.

Mu guhangana n’ikibazo cy’udukoko tugira ubudahangarwa ku miti kandi u Rwanda ruri kwibanda mu gukoresha imiti itwica haba ku bantu no ku matungo.

Hazifashishwa arenga miliyari 1,4 Frw hitabwa ku buryo bugezweho bwo kwandikira abantu imiti, uburyo bwo gucunga ububiko bw’imiti n’ibindi.

Hazibandwa ku gushishikariza abantu gushora mu bushakashatsi ku miti mishya, inkingo, uburyo bugezweho bwo gutahura indwara n’ibindi. Iki gice kizifashishwamo miliyoni 161 Frw. Ni mu gihe ibikorwa by’ubuhuzabikorwa bizatwara miliyari 513 Frw.

Icyakora ya mafaranga azajya atangwa uko umwaka utashye. Mu 2025 hatanzwe miliyari 6,3 Frw, mu 2026 hateganyijwe miliyari 9,7 Frw, mu 2027 hazatangwa miliyari 9,5 Frw, miliyari 7,4 Frw mu 2028 mu gihe mu 2029 ari na wo mwaka wa nyuma hazatangwa miliyari 6,9 Frw.

Ibikorwaremezo n’uburyo bwo kugenzura utu dukoko ni ingenzi, ni yo mpamvu hubatswe laboratwari 18 aho 12 zikoreshwa mu guteza imbere ubuzima bw’abantu mu gihe izisigaye zikoreshwa mu kubungabunga ubuzima bw’imyamaswa.

U Rwanda rwubatse laboratwari 18 zo gupima udukoko tugira ubudahangarwa ku miti, zivuye kuri esheshatu rwari rufite mu 2024.

U Rwanda rwashyize imbaraga mu kubaka laboratwari zifashishwa mu guhangana na AMR

Izi laboratwari zifashishwa mu kureba imiti itagihangana n’utu dukoko, zinafashe mu gupima udukoko mu mpagararizi, umuganga akaba yamenya umuti wakora kuri utu dukoko hamaze kumenywa ubushobozi bwatwo.

Ibi bizagirwamo uruhare n’urwego rw’ubuzima mu Rwanda rwubatswe mu buryo bukomeye. Izi gahunda zizagera mu turere 30 tw’u Rwanda imirenge 416, utugari 2.148 n’imidugudu 14.837.

Muri ibi bice ni na ho haherereye ibikorwaremezo by’ubuvuzi birimo ibitaro bikuru umunani, ibitaro bine by’intara, ibitaro 40 by’uturere, ibigo nderabuzima 515 n’amavuriro mato 1.243. Aha hose hatangirwa serivisi zo guhangana n’iki kibazo.

Abajyanama b’ubuzima barenga ibihumbi 58,5 bitezweho kugira uruhare mu kugeza serivisi z’ubuvuzi no gufasha mu gutanga amasomo ajyanye na AMR no kugenzura uko ihangaze.

Mu guteza imbere ubuzima bw’amatungo hazibandwa ku bikorwa byuzuzanya n’ibyo guteza imbere ubuzima bw’abantu. Bizakorerwa kuri sitasiyo 13 za RAB mu gihugu n’ abakozi bashinzwe amatungo 30 bo ku rwego rw’uturere n’abandi 416 bo ku mirenge.

Bizafasha mu buryo bwo kugenzura, gutanga ubujyanama mu bworozi, no gufasha mu gutanga imiti yagenewe mu guhangana n’iki kibazo.

Nubwo hari gushyirwa imbaraga mu kugabanya ikoreshwa ry’imiti ya ‘antibiotique’ no kwirinda kuyikoresha nabi, hafi ya 70% ikoreshwa mu bworozi, ibituma hakomeza kubaho indiri y’utu dukoko twifitemo ubushobozi bwo guhangana n’imiti yagenewe kuzica.

Imibare irivugira. Kuva mu 2019 kugeza mu 2021, u Rwanda rwatumije mu mahanga imiti ya ‘antibiotique’ yo gukoresha mu buvuzi bw’amatungo. 50,3% by’iyi miti ni ukuvuga toni 17,7 zari iza ‘tetracyclines’, sulfonamides yihariye 22,3% mu gihe iya ‘aminoglycosides’ yihariye 11,5%.

Ibi bisobanuye ko ari ingenzi mu gucunga uko ikoreshwa hirindwa ko udukoko twakubaka ubudahangarwa kuri yo.

Mu bitaro ho udukoko twamaze kubaka ubudahangarwa ku miti myinshi ya ‘antibiotique’ ku buryo bigoye kuvura indwara duteza.

Nka 86% by’udukoko bifite ubudahangarwa ku miti ya ampicillin ifasha mu kuvura indwara zirimo izifata ubwonko, 82% by’udukoko dutera indwara tukagira ubudahangarwa ku miti ya amoxicillin-clavulanic acid yagenewe kuvura ‘infections’ zifata inzira y’ubuhumekero mu gice cy’amazuru.

Udukoko 79% ntitugihangarwa n’imiti ya amoxicillin yagenewe kurwanya ibirimo indwara zifata amatwi, 69% by’udukoko ntitugihangarwa n’imiti ya cefadroxil yagenewe guhangana n’indwara z’uruhu, udukoko 60% natwo twigaranzuye imiti ya tetracycline yagenewe guhangana n’indwara z’uruhu na zimwe za ndurira mu mibonano mpuzabitsina n’ibindi.

Icyakora laboratwari z’u Rwanda na zo zagaragaje ubushobozi buhambaye bwo gupima utu dukoko. Ku bitaro by’akarere bigeze kuri 85,5%. Bivuze ko mu bipimo 100, 85,5% ni ibizubizo biri byo. Ni mu gihe za laboratwari y’igihugu biri kuri 90%.

Ikindi gishimishije ni uko ubushakashatsi bwagaragaje mu Rwanda, 95% by’abanyeshuri biga ubuvuzi bazi neza ko gukoresha imiti ya ‘antibiotique’ nabi bishobora gutuma habaho ikibazo mu gihe 96% by’aba banyeshuri baherewe amakuru ya AMR ahandi hatari mu ishuri. Icyakora haracyari ikibazo kuko abanyeshuri 49% bafata iyi miti batayandikiwe.

Abanyeshuri bangana na 12% biha ibiti batandikiwe bari kwivura nk’indwara zoroheje. Imiti ya Amoxicillin ni yo ikoreshwa cyane kurusha indi.

Ubushakashatsi bwagaragaje ko abanyeshuri 72% bafata imiti kuri za ‘pharmacie’ z’iwabo. Mu bitaro bikuru nibura abantu bane mu 10 baba barahawe bene iyi miti ya ‘antibiotique’. 65% by’iyi miti ishobora gutuma udukoko irwanya twongera ubudahangarwa kuri yo.

Ku matungo na ho ubushakashatsi bwagaragaje ko aborozi 52,6% bafite ubumenyi busabwa mu kwita ku matungo ndetse 56% bafite ubushake bwo kuyitaho mu gihe abagera kuri 52,8% bubahiriza imigirire ikwiriye mu kwita ku matungo yabo.

Guhangana na AMR bisaba gukora ibizamini bitandukanye