Drug Resistance Working Group
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November 2007 - Present With both the public and private sectors working to increase access to existing products in the poorest countries and encourage the development of new ones, it has become more important than ever to ensure that medicines are used appropriately to retain effectiveness and that the pipeline for new medicines is re-supplied with drugs for the long-term. The current system of incentives for distribution, use, and new development does not achieve that goal. Instead, the recent gains in access to treatment are threatened by a variety of factors leading to inappropriate drug use, including wrong dosages and drug choices, and poor quality or even counterfeit drugs. Together, these factors conspire to permit resistant disease strains to flourish, ultimately leading to therapeutic failure, greater medical costs, and extended and sometimes futile efforts to cure patients of what should be easily treatable diseases. The direct economic costs of drug resistance are incurred by longer medical treatment, higher-priced second-line therapies, the development of replacement drugs for those that no longer work, and additional screening and diagnostics to prevent the spread of resistant strains, while indirect costs arise from poor patient health, excess mortality and expensive risk-reduction efforts required to limit the spread of the resistant pathogens. From the perspective of donors – who are funding a large proportion of essential medical technologies for use in developing countries – drug resistance should raise serious concerns. In fact, the huge increases in drug delivery being funded by these same donors is responsible for increased risk of resistance at a time when developing country health systems have not received the same degree of largesse. The transnational nature of infectious diseases makes the containment of resistant strains a truly global public good, which is 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 global donor community could prevent or contain the emergence of drug resistance affecting high-burden diseases in developing countries. Concept Paper Access the background paper on Drug Resistance as a Global Health Policy Priority, which outlines the magnitude of drug resistance against AIDS, malaria, tuberculosis and other bacterial infections; discusses the rationale for global policy action; and identifies promising avenues for exploration. Approach The Working Group will focus on the potential for solutions effected collectively or individually by organizations that operate at the global level. The Group will draw on the strength of its diverse composition to extend the problem-solving conversation around drug resistance into and among communities that all have an interest, but rarely have the opportunity to forge joint solutions. In doing so, they will stimulate each other’s active commitment to address the problem, possibly through changes in funding, policies and program implementation. The process will be conducted in several stages, beginning with the identification of key characteristics of drug resistance in developing countries. From the initial mapping of the resistance problem, the Group will agree upon a feasible scope of work, identify relevant data and other information sources, and commission new analyses as needed. Specific steps are expected to include:
The main product of the Working Group will be a policy report identifying practical and feasible actions (anticipated in late 2008). The report will include recommendations for the global donor community, outlining the responsibilities different actors should bear, while pointing out opportunities and needs at the local, national, and intra-institutional levels. The findings will be disseminated to decision-makers in key development and funding organizations, as well as key private sector interests, through targeted briefings, events, and outreach. Leadership and Composition The Drug Resistance Working Group is led by Rachel Nugent, Senior Program Associate for Global Health, and includes experts from the pharmaceutical industry, public health sectors in developing and developed countries, technical and funding agencies, product development partnerships, advocacy organizations and academia.
Members serve in a personal capacity and on a voluntary basis. |