Drug Resistance & Global Health

Drug resistance is a major impediment to the successful treatment of HIV/AIDS, tuberculosis, and malaria – the three diseases prioritized for urgent action in developing countries – as well as serious illnesses such as pneumonia, diarrhea and other common infections worldwide. Resistance emerges in response to epidemiological, socio-economic, and behavioral conditions stemming from common breakdowns in health systems, which have become more acute with new infectious disease burdens and investments in treatment. As a result, the significant investments being made in drug research and development, and in improving health care delivery in developing countries, could be undermined by an increasingly ineffective range of therapeutic options, while developed countries also face increased health threats from the spread of multi-drug resistant strains of diseases.

Multilateral organizations, donors in global public health, the biopharmaceutical industry, developing country governments and health care providers all have an interest in reducing the development and spread of drug resistance. The transnational nature of infectious diseases makes the containment of resistant strains a truly global public good, dependent on international medical markets and the underlying web of transnational donor assistance, regulatory requirements and trade regimes. The public health benefits of greater drug availability will only be achieved with proper alignment of the incentives facing global actors and policy conditions that can reduce the threat of drug resistance. To address this critical challenge, the Center for Global Development convened the Drug Resistance Working Group in Fall 2007 to identify practical and feasible ways that the donor community could prevent or contain the emergence of drug resistance affecting high-burden diseases in developing countries through improvements in common property management, information flows and R&D investments.