Opinion

Pursuing Universal Health Coverage and Addressing the Challenge of Antimicrobial Resistance

Published on 21 May 2018

Tom Barker

Senior Health & Nutrition Convenor

The World Health Organization (WHO) and world leaders are giving high priority to initiatives to make progress towards universal health coverage (UHC) and to address the challenge of antimicrobial resistance (AMR). Governments, international agencies, and industry must work together at national, regional and global levels, so that actions to secure people’s access to effective treatment for common infections are aligned with efforts to reduce the risk of emerging AMR.

On 30-31 May 2018, the Asia-Europe Foundation (ASEF) Public Health Network and Ministry of Foreign Affairs of Japan, with technical input from the Institute of Development Studies (IDS), UK, are co-hosting a multi-country, high-level meeting focusing on the pursuit of UHC in the context of the effective management of infectious diseases and emerging AMR.

Poor access and inappropriate use

In many countries, people living in poverty live in environments that put them at higher risk of being unwell, including from infectious diseases contracted through contaminated water or exposure to others who are sick. Many die from treatable infectious diseases because health services are unavailable or too expensive.

As a result of poor access to health services, people seek health care in large unregulated, informal, and less expensive markets. These health care providers often lack sufficient medical knowledge, and sell drugs, including antibiotics, to make a living.

Under these circumstances, widespread inappropriate use of antimicrobials is combined with inadequate access to them, especially for poor people. These practices may increase the risk of drug resistance, leading to infections becoming more difficult to treat and making surgical procedures much riskier.

Regional collaboration needed

Since resistant organisms can move freely across national borders, national and regional responses are required that involve government and non-government actors.

The two day meeting in Tokyo will:

  • bring together officials with responsibilities for AMR and UHC and other stakeholders from Asia and Europe to explore the challenges they face in both ensuring access to antibiotic treatment, when needed, and reducing the risk of AMR;
  • identify practical strategies for integrating a concern for AMR into strategies for making progress towards UHC and for taking UHC strategies into account in national action plans for addressing AMR;
  • seek agreement on priorities for international cooperation between Asia and Europe to support an equitable and sustainable approach for addressing the challenge of infectious diseases.

Just and sustainable

Past and present efforts to strengthen health systems have tended to neglect measures to ensure access to appropriate antibiotic treatment of infections. And yet, if UHC is to be achieved by 2030 – the target for the UN’s Sustainable Development Goals (SDGs) – it is important that we understand the close links between UHC and AMR.

Effective strategies for addressing AMR need to ensure access to effective therapy for common infections and reduce the risk of emergence of resistance. We hope this meeting will make an important contribution to convening and mobilising key stakeholders to work together to ensure access to antimicrobials is both just and sustainable.

Disclaimer
The views expressed in this opinion piece are those of the author/s and do not necessarily reflect the views or policies of IDS.

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