Dr. Ali El-Ghamrawy, Chairman of the Egyptian Drug Authority (EDA), participated in the 3rd Medical Conference on the Optimal Use of Antibiotics and Infection Control, in the presence of Prof. Dr. Mohamed Awad Tag El-Din, Advisor to the President of the Republic for Health and Prevention Affairs; Dr. Ahmed El-Sobky, Chairman of the General Authority for Healthcare and General Supervisor of the Universal Health Insurance and Decent Life projects at the Ministry of Health and Population; Dr. Hisham Stait, Chairman of the Unified Procurement Authority; Dr. Ahmed Taha, Chairman of the General Authority for Healthcare Accreditation and Regulation; and Dr. Nimaa Abid, World Health Organization (WHO) Representative in Egypt.
The conference aims to highlight the growing challenges associated with the misuse of antibiotics and the consequences of the spread of treatment-resistant infections. It also seeks to raise medical awareness about best practices in infection control and to reduce health complications resulting from bacterial resistance.
In his speech, the Chairman of the EDA stressed that bacteria develop defensive mechanisms that protect them from antibiotics, making them drug-resistant. This poses an urgent global threat not limited to human health, but also affecting animal health and the environment, with negative repercussions on the global economy and sustainable development. The WHO has listed antimicrobial resistance among the top ten global health threats. Some estimates indicate that around 5 million deaths were linked to antimicrobial resistance in 2019, and this number is expected to reach 10 million annually by 2050.
He pointed out that the Egyptian pharmaceutical market is one of the largest regional markets, with a financial value of EGP 309 billion. It includes more than 12,000 pharmaceutical products with total sales of 3.5 billion packages. Antibiotics make up 887 products with total sales of 407 million packages, accounting for approximately 11.6% of total market sales in 2024. Notably, non-prescription use constitutes 55% of antibiotic sales according to the latest statistics.
This high volume of antibiotic consumption places a significant responsibility on the EDA to ensure their rational use. The EDA has joined the WHO antimicrobial consumption surveillance program and monitors national usage rates, reporting data to the global platform based on the Defined Daily Dose (DDD) system. This allows for comparative analysis between Egypt’s antibiotic use and that of other countries.
In 2023, total antimicrobial consumption in Egypt reached 30.96 DDD per 1,000 inhabitants per day. Based on WHO’s AWaRe classification, 59% of use was in the Access group, 39.4% in the Watch group, and 1.2% in the Reserve group. The EDA is working toward rational antibiotic use and has taken data-driven decisions, such as issuing a decision to regulate antibiotic dispensing—banning over-the-counter sales of certain antibiotics without a prescription. The EDA also issued a regulatory guide for dispensing antibiotics in the Reserve group as an initial step. To monitor compliance, 507 high-consumption pharmacies and institutions were inspected between July 2024 and February 2025. Violations were recorded in 42 institutions, which were subsequently suspended from antibiotic supply in accordance with the regulatory guide.
These efforts led to a 38.4% reduction in the number of injectable Reserve antibiotic packages sold by March 2025, with sales dropping to 138,000 packages compared to 224,000 in August 2024 when the decision was first implemented. Work is underway to extend regulation to the Watch group to minimize unsafe antibiotic use and standardize antibiotic policies and practices in line with international standards, ultimately benefiting Egyptian patients.
The antibiotic consumption monitoring system was updated to include dosage form data. According to 2023 estimates, oral antibiotics represented 95.33% of total consumption, followed by injectable forms at 4.66%. Data is also categorized by level of healthcare (hospitals and public pharmacies) and by hospital sector (public vs. private). Notably, institutional (public sector) consumption accounted for 18.7%, while the local market (private sector) comprised 81.3%.
Dr. El-Ghamrawy emphasized the importance of local and international cooperation in combatting antimicrobial resistance. Key initiatives include collaboration with WHO on events related to antibiotic consumption data, working with the UN’s Food and Agriculture Organization and the General Authority for Veterinary Services to train veterinarians on consumption rate calculation, participating in the development of the national antimicrobial resistance strategy, joining the global regulatory network on AMR, contributing to Egypt’s One Health strategic framework, and updating the national AMR action plan draft.
On the awareness front, Dr. El-Ghamrawy affirmed the EDA’s commitment to launching initiatives for appropriate antibiotic use awareness. These include community campaigns like the “Your Medicine Is Your Safety” initiative, which targets cultural centers, social clubs, and visitors to the EDA. Educational outreach to government-sector pharmacists is also carried out via the Pharmaceutical Care Initiative, with participation from WHO representatives and university faculty members. Additionally, the “Triple Es” initiative serves as a center for experience exchange.

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