International health experts have begun to shift their focus to try to provide access to basic drugs in countries where preventable deaths from infections occur too frequently.
An impoverished family in Africa is unable to afford a 50-cent course of antibiotics to save the life of a child with a simple bacterial infection. Is such a tragedy best described as a case of antimicrobial resistance, the slow-motion health emergency caused by the misuse of lifesaving antibiotics?
For more than a decade, antimicrobial resistance has been framed as a problem of excess. The willy-nilly consumption of antibiotics, scientists said, have rendered the drugs less effective, leading to the unnecessary death of millions, many of them poor.
But as global health officials gathered at the United Nations on Thursday to discuss the challenges posed by antimicrobial resistance, many have been promoting a more expansive understanding of the problem. It’s one based on preventing treatable infections through improved sanitation, higher vaccination rates and increased access to anti-infective drugs in lower-income countries.
“Millions of people around the world have never even taken an antibiotic because they can’t afford them,” said Dr. Ramanan Laxminarayan, an economist and epidemiologist who has been promoting this new approach to antimicrobial resistance, much of it detailed in a recent series of journal articles in The Lancet. “We’re trying to move away from the issue of resistance, which is hard for the public to understand, and more to entitlement, which is that everyone should have access to an effective antibiotic.”
Threading that needle — promoting greater access to antibiotics in some places while seeking to limit their use in others — won’t be easy.
In the eight years since the U.N. held its first high-level meeting on antimicrobial resistance, the world has become increasingly familiar with the threats posed by untreatable infections.