Access to effective antimicrobials is crucial to any healthcare system, but in many countries, necessary antimicrobials are not available to patients because they have not been registered and/or introduced. This introduction barrier is particularly prevalent in low- and middle-income countries (LMICs). Not only does this directly cause mortality and morbidity, but, by leaving infections to spread unchecked, it can also lead to increased rates of resistance.
Through interviews with experts, we sought to learn why LMICs see fewer antimicrobial registrations and product introductions than other countries—what we refer to as the “rollout problem.” We wanted to understand why large pharmaceutical companies may not register and introduce antimicrobial products in LMICs and to identify potential solutions to overcome these barriers. This was not intended as an exhaustive analysis of the problem, but carried out as part of CGD’s Working Group on antimicrobial resistance (AMR) to understand if this is an issue which should be addressed in future research and agreements on AMR. While we focused on registration and introduction, it is important to note that this is not the only barrier to access: for example, if a country cannot afford the price of a new drug, there is no use in pushing for registration. Additionally, while our research focused on the rollout problem for novel antimicrobials, a complete understanding of access problems also requires consideration of issues around generics and other older anti-infectives, some of which are coming back into use.
Read the full note here.
