International cooperation to improve access to and sustain effectiveness of antimicrobials

Abstract

Securing access to effective antimicrobials is one of the greatest challenges today. Until now, efforts to address this issue have been isolated and uncoordinated, with little focus on sustainable and international solutions. Global collective action is necessary to improve access to life-saving antimicrobials, conserving them, and ensuring continued innovation. Access, conservation, and innovation are beneficial when achieved independently, but much more effective and sustainable if implemented in concert within and across countries. WHO alone will not be able to drive these actions. It will require a multisector response (including the health, agriculture, and veterinary sectors), global coordination, and financing mechanisms with sufficient mandates, authority, resources, and power. Fortunately, securing access to effective antimicrobials has finally gained a place on the global political agenda, and we call on policy makers to develop, endorse, and finance new global institutional arrangements that can ensure robust implementation and bold collective action.

Sustained reduction in antibiotic consumption in a South African public sector hospital; Four year outcomes from the Groote Schuur Hospital antibiotic stewardship program

“…[1][2][3] South Africa (SA) has seen an alarming increase in rates of extended-spectrum beta-lactamase (ESBL)-producing Gram-negative bacteria [4][5] and carbapenem-resistant Enterobacteriaceae (CRE), which have been reported from every province. [6] The main driver of antibiotic resistance is overuse and misuse of antibiotics.…”

Addressing the Unknowns of Antimicrobial Resistance: Quantifying and Mapping the Drivers of Burden

“…Collaborative action by the global public health community is necessary to determine the relative contributions of sources and transmission routes to AMR [25,26], including the most relevant environments and drivers at local, national and global levels (Figure 1). While there are current efforts to identify drivers of AMR in different environments,[1, 27] a comprehensive approach is lacking.…”

Delinking Investment in Antibiotic Research and Development from Sales Revenues: The Challenges of Transforming a Promising Idea into Reality

“…All options could potentially implement a "top-up" system requiring high-income countries to pay a higher price than the completive price close to marginal cost. collaboration and the trust in that doing so will accrue benefits immediately and over the long term [24]. Global political commitment is needed now to transform antibiotic delinkage from a promising idea into reality.…”