Lack of access to antibiotics is a key driver of antimicrobial resistance

Lack of access to antibiotics is a key driver of antimicrobial resistance

Sustainable access to antibiotics in low- and middle-income countries is crucial
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A recent webinar during the World Antimicrobial Awareness Week brought up one of the important factors driving up antimicrobial resistance — access to antibiotics, specially first-line treatments. 

When bacteria, viruses, fungi and parasites change over time and no longer respond to medicines, it makes infections harder to treat. This increases the risk of disease spread, severe illness and death, also known as antimicrobial resistance (AMR). 

AMR phenomenon leads to deaths, morbidity, high treatment cost, increased hospital stays and also losses in animal productivity and economic and livelihood losses. It was responsible for approximately 5 million deaths in 2019, according to a recent study. 

Limited or no access to antibiotics, including existing first-line general treatments, is a key driver of AMR. When the right antibiotics are not locally accessible, a doctor may resolve to prescribe a less effective alternative antibiotic that is unlikely to cure the patient’s infection and likely to contribute to antimicrobial resistance. 

A panel discussion November 23, 2022 raised the importance of sustainable access to antibiotics and antifungals in low- and middle-income countries (LMICs). It was hosted by non-profit Access to Medicines Foundation. 

The discussion was open to the general public and had panelists from the World Health Organization (WHO), The Global Antibiotic Research and Development Partnership (GARDP), Access to Medicines Foundation and Cipla Ltd.  

The overall aim of the discussion was to address the issue of sustainable access to existing antibiotics and provide insights on how to identify the right public health partners, harmonise registration across regions, define local demand to introduce generic medicines and support local manufacturing and technology transfers in LMICs.

An important topic that came up was the need to ensure access to antibiotics used as first-line treatments. 

In 2017, the WHO classified antibiotics into three groups, Access, Watch and Reserve. It took into account the impact of different antibiotics and antibiotic classes on AMR. 

‘Access’ group includes antibiotics that act against a wide range of commonly encountered susceptible pathogens while also showing lower resistance potential than antibiotics in the other groups. ‘Selected access’ group antibiotics are recommended as essential first or second-choice empiric treatment options for infectious syndromes.

Another topic that was touched upon during the webinar was the need for data collection, “Generating data on resistance patterns in individual countries would help give an estimate of the disease burden of that country and appropriate actions can be taken,” recommended Jaideep Gogtay, chief medical officer at Cipla Ltd.

This was seconded by Jennifer Cohn, director of GARDP. “Better evidence, better knowledge of demands and coordinated effort would be essential in combating AMR,” Cohn said. 

The webinar ended by highlighting the importance of partnerships and collaboration between stakeholders to ensure equitable access to antibiotics for all. 

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