Dr. Ali El-Ghamrawy, Chairman of the Egyptian Drug Authority (EDA), participated in the Second National Conference to follow up on the implementation of infection control activities and the national plan to combat antimicrobial resistance (AMR), in the presence of Professor Dr. Khaled Abdel Ghaffar, Deputy Prime Minister for Human Development and Minister of Health and Population.
In his speech, Dr. Ali El-Ghamrawy emphasized that AMR develops as microbes evolve defensive mechanisms that shield them from the effects of antimicrobial agents, making them unresponsive to treatment. This poses an urgent global threat, impacting not only human health but also animal health, the environment, the global economy, and sustainable development. The World Health Organization (WHO) has classified AMR as one of the top ten global health threats, with estimates indicating that 4.95 million deaths were linked to antimicrobial resistance in 2019, and this number is expected to rise to 10 million deaths annually by 2050.
He highlighted that the Egyptian pharmaceutical market is one of the largest regional markets, with a financial value of EGP 308 billion, encompassing over 12,000 pharmaceutical products and total sales reaching 3.6 billion units. Antimicrobials account for 887 products, with total sales of 376 million units, representing 10% of the total pharmaceutical market. Notably, 55% of antimicrobial sales come from non-prescribed use, according to the latest statistics. This significant level of antimicrobial consumption places a great responsibility on the EDA to ensure their rational use through three key pillars.
The first pillar focuses on monitoring antimicrobial consumption. The EDA has joined the WHO’s Global Antimicrobial Resistance and Use Surveillance System (GLASS-AMR), enabling close tracking of national consumption rates and reporting data to the global platform using the Defined Daily Dose (DDD) system which provides an opportunity to compare consumption rates in the Arab Republic of Egypt with consumption rates in different countries of the world.

Additionally, efforts are being made to ensure the rational use of antimicrobials by implementing evidence-based decisions, such as the issuance of the decree on the dispensing and monitoring of antibiotics, which restricts the sale of certain antibiotics in pharmacies without a medical prescription. The authority has also published regulatory guidelines for the dispensing of reserve antibiotics as an initial step toward stricter control and measurement of the extent of pharmaceutical institutions' commitment towards implementation. To enforce these regulations, inspection campaigns were conducted at 513 high-consumption pharmaceutical institutions, resulting in violations at 13 institutions, which were subsequently suspended for three months. The next phase includes the issuance of a ""Watchlist"" to further limit unsafe antimicrobial use and standardize policies and procedures based on global standards, ultimately benefiting Egyptian patients.
These efforts have led to a nearly 20% reduction in the number of reserved injectable antibiotic vials sold within the first year of implementation. Sales dropped to 751,000 units in the period following the issuance of the guidelines (July–December 2024), compared to over 938,000 units in the same period of 2023. Additionally, the antimicrobial consumption monitoring system has been updated to classify consumption by dosage form. According to the latest estimates, oral formulations account for 95.33% of consumption, followed by parenteral products at 4.66%. Furthermore, consumption has been categorized based on healthcare levels (hospitals and private pharmacies) and classified within hospitals into public and private sectors. Notably, the institutional market (public sector) accounts for 18% of antimicrobial consumption, while the private sector represents 82%.
He pointed out that the second pillar focuses on collaboration with local and international institutions. The EDA strongly believes in the importance of international and local cooperation to enhance efforts in combating AMR. Key initiatives include cooperation with the WHO in conferences and events on using antimicrobial consumption data to improve prescribing practices, collaboration with the Food and Agriculture Organization (FAO) and the General Organization for Veterinary Services to develop training programs for veterinarians on calculating antimicrobial consumption rates in the veterinary sector, as well as developing a national strategy to combat AMR. The EDA has also joined the Regulatory Agencies Global Network on Antimicrobial Resistance (RAGNA) and participated in the national strategic framework for “One Health” in Egypt. Additionally, the EDA has contributed to updating the draft National Action Plan for Combating Antimicrobial Resistance.
He added that the third pillar focuses on awareness efforts. The EDA places significant emphasis on awareness campaigns and initiatives to promote the rational use of antimicrobials. These include public awareness campaigns under the initiative ""Your Medicine, Your Safety,"" targeting cultural palaces and social clubs, as well as direct awareness sessions for visitors at the EDA’s premises. Furthermore, awareness programs for hospital pharmacists and community pharmacists have been launched under the initiative ""An Informed Pharmacist, an Aware Community - Unlock The Pharmacist Potentials."" Special attention is also given to university students, particularly pharmacy students, through competitions and programs such as ""Future Fighters against AMR,"" in collaboration with the WHO and pharmacy faculties in Egypt. This initiative has showcased students' creative ideas and innovative approaches to spreading pharmaceutical awareness under academic supervision to ensure content accuracy and quality.

Dr. El-Ghamrawy emphasized that tackling AMR is not the responsibility of a single entity but rather a shared commitment among governments, health organizations, the pharmaceutical sector, and society as a whole. Achieving rational antibiotic use, strengthening surveillance systems, and fostering cooperation across sectors are fundamental to protecting future generations from this escalating crisis. He reaffirmed the EDA’s commitment to supporting all initiatives and policies that ensure the availability of safe and effective antimicrobials while maintaining a balance between meeting patients' needs and protecting public health.
This comes within the framework of the EDA's keenness to address the phenomenon of antimicrobial resistance, cooperation and joint coordination with all relevant stakeholders and aligning with the WHO’s global agenda to combat this issue.