The Center for Global Development, a DC think-tank, is releasing what looks like a thoughtful report aimed at refocusing policy debates over drug resistance toward the epidemic's global impact, with particular attention to the the developing world.
From the report's preface:
Problems with drug resistance have moved from the patient's bedside to threaten global public health. Drug resistance has dramatically increased the costs of fighting tuberculosis (TB) and malaria, has slowed gains against childhood dysentery and pneumonia, and threatens to undermine the push to treat people living with HIV/AIDS effectively. Global health funders and development agencies have cause to worry about whether their investments in access to drugs, and global health programming more broadly, are being undone by the relentless advance of drug resistance.
It calls out a sustained lack of leadership:
Past efforts to energize global action to more comprehensively address drug resistance have been sidetracked by poor timing or over-stretched budgets... In an unfortunate coincidence of timing, a WHO Strategy on Antimicrobial Resistance was launched on September 11, 2001. As a result, the action plan prepared for the Strategy did not get carried out, and over time the interest in cross-cutting drug resistance at WHO withered, even while disease-specific attention grew. For many years, the U.S. Government provided support for research, technical support, surveillance, and policy development on drug resistance in developing countries through an annual budget appropriation to the U.S. Agency for International Development (USAID). That support has become narrowed to programming in only a few areas.
It recommends 4 specific steps:
- Improve surveillance by collecting and sharing resistance information across networks of laboratories
- Secure the drug supply chain to ensure quality products and practices
- Strengthen national drug regulatory authorities in developing countries
- Catalyze research and innovation to speed the development of resistance-fighting technologies