News and Opinions  –  2019

ReAct policy brief: Antimicrobial resistance and universal health coverage – What’s the deal?

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Last July, ReAct and the South Centre jointly organized a conference in Nairobi, Kenya on ‘Achieving Universal Health Coverage while Addressing Antimicrobial Resistance’. Based on the insights from experts in antimicrobial resistance and universal health coverage from 33 different countries ReAct wrote a policy brief linking universal health coverage to antimicrobial resistance. The policy brief shows why antimicrobial resistance seriously threatens achieving universal health coverage, but also how their respective policies go hand in hand.

Woman listening to baby in stomach. Text: Antimicrobial resistance and universal health coverage - what's the deal? And a quote from Mirfin Mpundu, Head of ReAct Africa.
Click photo to download Antimicrobial resistance and universal health coverage – What’s the deal? Photo: Photoshare.

Managing antibiotic resistance will be critical to achieve universal health coverage

Effective antibiotics are critically important cornerstones for a health system. Antimicrobial resistance would therefore seriously jeopardize the achievement of universal health coverage as:

  • Without sustainable and effective treatment of infections, good quality health care for all will not be reached.
  • Without management of antimicrobial resistance, sustainable financing of universal health coverage will be difficult.

Pay now, or pay much more later

The World Bank estimates that between 1.1% and 3.8% of global GDP could be lost due to antimicrobial resistance if left unchecked by 2050. Failure to manage antimicrobial resistance leads to resistant infections that require more and longer hospitalizations (inpatient care) and need for more expensive treatment options. The morbidity and mortality attributable to these resistant infections also bear enormous societal costs.

Sustainable financing of universal health coverage needs to consider the current and long-term risks of antimicrobial resistance: the choice therefore is to pay now, or pay much more later.

What has stood out, which is a great achievement and which need emphasis, is mainstreaming of antimicrobial resistance into the existing government framework. Malawi has managed to do that – to mainstream antimicrobial resistance. We are called for meetings even for HIV/AIDS and for many other programs, because they critically understand that antimicrobial resistance is a challenge and the program can be incorporated into the system, and we can unite resources.

Watipaso Kasambara, Antimicrobial Resistance Coordinator Malawi

Managing antibiotic resistance within universal health coverage

For a universal health coverage strategy to be truly successful, it has to address antimicrobial resistance. An essential part of implementing universal health care is to strengthen health care systems to provide access to quality care. These system strengthening measures will concurrently contribute to managing antimicrobial resistance. For instance, the expansion of primary health care, access to essential medicines and diagnostics, access to clean water and sanitation, prevention of infections, increased vaccination coverage and other measures are important components of antimicrobial resistance programs that improve quality of care. This illustrates that antimicrobial resistance and universal health coverage go hand-in-hand. The policy brief shows how antimicrobial resistance can be included in different health system interventions also needed for universal health coverage.

5 initial steps to manage antimicrobial resistance within universal health coverage strategies

  1. Amplify the message that: ‘Achieving universal health coverage and managing antimicrobial resistance go hand in hand’.
  2. Build political commitment to invest now in measures to address antimicrobial resistance. Failing to do so will result in paying much more later. Antimicrobial resistance threatens the sustainable financing of universal health coverage in national health systems.
  3. Identify entry points through which antimicrobial resistance can be addressed in national universal health coverage strategies and how resources can be united.
  4. Advocate for inclusion of antimicrobial resistance in broader health and development programs at global, regional and national level.
  5. Build strong one health platforms for collaboration across sectors, and ensure greater coordination between the universal health coverage and antimicrobial resistance strategies.


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