Jennifer Cohn, MD, MPH
Global Access Director, GARDP
Accessing the right antibiotic at the right dose and at the right time can mean the difference between life and death for a patient with a serious bacterial infection.
Lack of antibiotic access acutely affects people with drug-resistant infections in need of new antibiotics. One study found that only 10 of the 25 new antibiotics that entered the market between 1999 and 2014 were registered in more than 10 countries.
The result is that vulnerable people — including children, cancer patients, the elderly and especially those in low and middle-income countries — suffer and die from potentially treatable bacterial infections. Doctors without access to the most appropriate treatment may resort to suboptimal treatments that facilitate the spread of drug-resistant bacteria, thus fuelling antibiotic resistance.
Drug development to antibiotic treatments
The situation is clear: to address antibiotic resistance and save lives, we need to expand global access to antibiotics and ensure they are used appropriately.
Access provisions should be built into funding agreements with antibiotic developers. Pre and post-approval studies should consider the data needed for registration plus the data needed by clinicians and policymakers to optimise the appropriate use of the drug.
By addressing access at all stages of antibiotic development, we can contribute to equitable access now and in the future.
Countries with high burdens of bacterial resistance should collaborate closely to define priorities and set research agendas.
Addressing access from every angle
Access to antibiotics encompasses affordability for the local population, availability at the right time and place (eg. reliable supply), data and guidelines for different population groups (eg. adults and children) and appropriate use to minimise resistance.
Clinicians need useful data — including diagnostic data and local data on antibiotic resistance — to use the right treatment quickly and appropriately in situations where delays can make the difference between life and death.
Data should also be used to develop up-to-date, practical and evidence-based usage guidelines that can be adapted to regional contexts. We must facilitate the availability of quality-assured, affordable antibiotics through interventions like voluntary licensing of patented products and pooled procurement of treatments.
Working with local and regional partners
Countries with high burdens of bacterial resistance should collaborate closely to define priorities and set research agendas.
They can also collaborate on national and regional interventions, such as creating strong, regionally aligned guidelines for the diagnosis and treatment of bacterial infections and developing simplified processes to approve new antibiotics.
Antibiotic resistance is on the rise. Antibiotic access can help counter it.
