New publication! Equitable access to antibiotics: A core element for pandemic preparedness and response

2023-03-29

In an article published in the latest Symposium Issue of the Journal of Law, Medicine & Ethics "Antimicrobial Resistance Must Be Included in the Pandemic Instrument to Ensure Future Global Pandemic Readiness", ReAct calls for securing equitable and sustainable access to effective antibiotics and other countermeasures to be a key consideration in the upcoming pandemic instrument.

With the ongoing process of the Intergov­ernmental Negotiating Body to negotiate a new instrument for pandemic prevention, prepared­ness, and response, this special issue of the Jour­nal of Law, Medicine & Ethics explores the inclusion of antimicrobial resistance (AMR) within the Pandemic Instru­ment from three perspectives:

1. through the lens of global AMR governance
2. from the perspective of technical governance challenges and opportunities affecting the global ability to address antimicrobial resistance and future pandemics and
3. from the perspective of pandemic instrument mechanisms for strengthening global AMR gov­ernance.

Each paper offers concrete recom­mendations with respect to the importance of including antimicrobial resistance within the scope of the pandemic instrument.

The ReAct article emphasizes the critical importance of equitable access to antibiotics as a fundamental element of pandemic preparedness and response. It highlights the disproportionate impact of the lack of access to effective antibiotics, with low- and middle-income countries being the most affected. To achieve equitable access, a health systems approach is required, including the strengthening of preventive measures, diagnostics, and infrastructure, as well as coordinated efforts towards health workforce and quality care. Additionally, reforming antibiotic innovation to ensure equitable and sustainable access is crucial.

The publication outlines the key components that must be coordinated to achieve sustainable access to effective antibiotics, which can form important building blocks in a pandemic instrument. This involves coordinated action and adequate financing to ensure antibiotic effectiveness as a global public good.

Policymakers should consider the following 4 key messages when developing a new global agreement

1. Antibiotic effectiveness is a global public good, and preserving it is a shared responsibility.

Governments must take globally coordinated action to ensure equitable and sustainable access for all those in need.

2. Prevention of infections is one of the most cost-effective measures for reducing the need for antibiotics and managing antibiotic resistance.

The pandemic instrument should include minimum standards and target setting for infection prevention and control (IPC) and water, sanitation, and hygiene (WASH), reinforced by global goals, including achieving quality health for all.

3. Pandemic preparedness depends on an effective, global, integrated surveillance system.

Policymakers should explore the use of low-cost environmental surveillance, such as a global wastewater surveillance system. The pandemic instrument should support increasing diagnostic capacity, laboratory infrastructure, educated personnel, and strengthening national surveillance systems in LMICs. Integrated analysis of data across the human, animal, and environment sectors that account for both viral and bacterial threats is crucial.

4. The pandemic instrument should introduce standards, procedures, and clear mechanisms for monitoring and accountability, along with adequate financing and resources for implementation.

Public leadership is needed to institutionalize global prioritization, coordination, and long-term funding of Research & Development activities. low- and-middle-income countries must be given adequate resources to follow up mandates and measures, and rules-based governance, including transparency of data, global sharing of knowledge and technology, and equitable allocation and distribution, must be established.