The Center For Disease Dynamics, Economics & Policy: Access Barriers to Antibiotics


by Isabel Frost, Jess Craig, Jyoti Joshi, and Ramanan Laxminarayan



"In this report, researchers at the Center for Disease Dynamics, Economics & Policy (CDDEP) conducted stakeholder interviews in Uganda, India, and Germany, and literature reviews to identify key access barriers to antibiotics in low-, middle-, and high-income countries.


The report makes several recommendations proposing action on antibiotic and diagnostics research and development, strengthening regulatory capacities, encouraging the development and diversification of quality local manufacturing, exploring innovative funding to reduce out-of-pockets payments, raising awareness, and improving clinical treatment guidelines.


Researchers found that health facilities in many low- and middle-income countries are substandard and lack staff who are properly trained in administering antibiotics. In Uganda, 10 to 54 percent of health staff posts are unfilled because of poor pay, high stress, lack of resources, and poor management. Staffing on wards is inadequate to administer medicines, patients miss antibiotic doses, and public nurses sometimes request compensation for administering medicines. In India, there is one government doctor for every 10,189 people (the World Health Organization [WHO] recommends a ratio of 1:1,000), or a deficit of 600,000 doctors, and the nurse:patient ratio is 1:483, implying a shortage of 2 million nurses."


Pneumonia Innovations Network Co-Chair, Leith Greenslade, also comments, "Data like this help to underscore that access gaps are real and deadly." 



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Monday, 17 February 2020