Antimicrobial resistance: what pharmacists in Afghanistan can do

Antimicrobial resistance (AMR) happens when bacteria evolve so that the medicines used to treat them stop working. It makes common infections harder and more expensive to treat — and pharmacies, where most antibiotics in Afghanistan are dispensed, are on the front line.

The size of the problem

• The Global Research on Antimicrobial Resistance study (The Lancet, 2022) estimated that in 2019, 1.27 million deaths worldwide were directly caused by bacterial AMR, and 4.95 million were associated with it.
• Updated estimates for 2021 (The Lancet, 2024) put the figures at 1.14 million directly attributable and 4.71 million associated deaths, and forecast more than 39 million directly attributable deaths between 2025 and 2050 — with South Asia among the hardest-hit regions.

What studies in Kabul show

• In a study at a Kabul district hospital (PLOS One, 2021), 87% of people obtained their medicines from private pharmacies; 23% stopped antibiotics early, mostly because they felt better; and 35% kept antibiotics at home, most of them left over from earlier courses.
• Among 369 non-medical students at Kabul University (Medicine, 2025), 59.1% had used antibiotics without a prescription, and most obtained them from pharmacies.
• A 2025 review of Afghan studies reports high resistance in hospital settings, including methicillin-resistant Staphylococcus aureus in Kabul and carbapenem-resistant Acinetobacter in Kandahar intensive care units.

The WHO AWaRe framework

The World Health Organization groups antibiotics into three categories to guide use:

• Access — first- and second-choice antibiotics for common infections, with lower resistance potential.
• Watch — higher resistance potential; should be used for specific, limited indications.
• Reserve — last-resort options for multidrug-resistant infections.

The global target, endorsed at the UN General Assembly in 2024, is for at least 70% of antibiotic use to come from the Access group by 2030. Here is where antibiotics in the Deeva Light range fall:

Watch antibiotics are essential medicines. The point of the framework is not to avoid them, but to make sure they are used when they are the right choice — which protects their effectiveness for the patients who really need them.

Practical stewardship at the counter

The International Pharmaceutical Federation (FIP) sets out what pharmacists can do:

• Dispense antibiotics on a valid prescription and check that the medicine, dose and duration match the indication.
• Counsel patients to take the full prescribed course at the right times.
• Explain that antibiotics do not treat colds, flu or other viral infections.
• Discourage keeping leftover antibiotics at home or sharing them — and offer to take back unused medicines.
• Buy only from licensed, reputable suppliers to keep substandard and falsified antibiotics out of the supply chain.
• Promote hygiene, infection prevention and vaccination.

Deeva Light supplies antibiotics through licensed pharmacies, hospitals and distributors only. Browse the anti-infective range.

This article is for healthcare professionals and trade customers and does not replace the product insert or a prescriber’s judgement. Always follow the prescribing information supplied with the product.