Article Text

Download PDFPDF

Antimicrobial resistance and universal health coverage
  1. Gerald Bloom1,
  2. Gemma Buckland Merrett2,
  3. Annie Wilkinson1,
  4. Vivian Lin3,
  5. Sarah Paulin4
  1. 1 Institute of Development Studies, University of Sussex, Brighton, UK
  2. 2 Health Action International, Amsterdam, The Netherlands
  3. 3 Division of Health Systems, Western Pacific Regional Office of World Health Organization, Manilla, Philippines
  4. 4 Department of Essential Medicines and Health Products, World Health Organization, Geneva, Switzerland
  1. Correspondence to Dr Gerald Bloom; g.bloom{at}


The WHO launched a Global Action Plan on antimicrobial resistance (AMR) in 2015. World leaders in the G7, G20 and the UN General Assembly have declared AMR to be a global crisis. World leaders have also adopted universal health coverage (UHC) as a key target under the sustainable development goals. This paper argues that neither initiative is likely to succeed in isolation from the other and that the policy goals should be to both provide access to appropriate antimicrobial treatment and reduce the risk of the emergence and spread of resistance by taking a systems approach. It focuses on outpatient treatment of human infections and identifies a number of interventions that would be needed to achieve these policy goals. It then shows how a strategy for achieving key attributes of a health system for UHC can take into account the need to address AMR as part of a UHC strategy in any country. It concludes with a list of recommended priority actions for integrating initiatives on AMR and UHC.

  • health policy
  • health systems
  • public health

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

View Full Text

Statistics from


  • Parts of this paper have previously been presented in a WHO publication entitled: Anti-microbial Resistance in the Asia Pacific Region: A Development Agenda.

  • Handling editor Seye Abimbola

  • Contributors GB took the lead in preparing the draft, and GBM, AW, VL and SP contributed to the final text.

  • Funding This paper draws on a background paper commissioned by the Western Pacific Office of the World Health Organization. The work on producing the final draft of the paper was supported by a grant by the UK Department of International Development to the Future Health Systems Consortium.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.