Maximising access to achieve appropriate human antimicrobial use in low-income and middle-income countries

Marc Mendelson; John-Arne Røttingen; Unni Gopinathan; Davidson H Hamer; Heiman Wertheim; Buddha Basnyat; Christopher Butler; Göran Tomson; Manica Balasegaram

doi:10.1016/S0140-6736(15)00547-4

Maximising access to achieve appropriate human antimicrobial use in low-income and middle-income countries

Lancet. 2016 Jan 9;387(10014):188-98. doi: 10.1016/S0140-6736(15)00547-4. Epub 2015 Nov 18.

Authors

Marc Mendelson¹, John-Arne Røttingen², Unni Gopinathan³, Davidson H Hamer⁴, Heiman Wertheim⁵, Buddha Basnyat⁶, Christopher Butler⁷, Göran Tomson⁸, Manica Balasegaram⁹

Affiliations

¹ Division of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa. Electronic address: marc.mendelson@uct.ac.za.
² Norwegian Institute of Public Health, Oslo, Norway; Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Global Health and Population, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA.
³ Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway.
⁴ Zambia Center for Applied Health Research and Development, Lusaka, Zambia; Center for Global Health and Development, Boston University School of Public Health, Boston, MA, USA; Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, MA, USA.
⁵ Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, National Hospital for Tropical Diseases, Hanoi, Vietnam; Nuffield Department of Clinical Medicine, Centre for Tropical Diseases, Oxford, UK.
⁶ Oxford University Clinical Research Unit-Nepal, Kathmandu, Nepal.
⁷ Nuffield Department of Primary Care Health Sciences, Oxford University, Oxford, UK.
⁸ Departments of Learning, Informatics, Management, Ethics and Public Health Sciences, Karolinska Institute, Stockholm, Sweden.
⁹ Access Campaign, Médecins Sans Frontières, Geneva, Switzerland.

PMID: 26603919
DOI: 10.1016/S0140-6736(15)00547-4

Abstract

Access to quality-assured antimicrobials is regarded as part of the human right to health, yet universal access is often undermined in low-income and middle-income countries. Lack of access to the instruments necessary to make the correct diagnosis and prescribe antimicrobials appropriately, in addition to weak health systems, heightens the challenge faced by prescribers. Evidence-based interventions in community and health-care settings can increase access to appropriately prescribed antimicrobials. The key global enablers of sustainable financing, governance, and leadership will be necessary to achieve access while preventing excess antimicrobial use.

Publication types

Review

MeSH terms

Anti-Bacterial Agents / therapeutic use*
Bacterial Infections / diagnosis
Bacterial Infections / drug therapy
Delivery of Health Care
Developing Countries*
Diagnostic Tests, Routine
Drug Resistance, Microbial
Drugs, Generic
Evidence-Based Practice
Financing, Organized
Health Services Accessibility*
Humans
Inappropriate Prescribing
Point-of-Care Systems
Practice Guidelines as Topic
Primary Prevention
Quality Control
Vaccination

Substances

Anti-Bacterial Agents
Drugs, Generic

Abstract

Publication types

MeSH terms

Substances

Grants and funding