Population mobility, globalization, and antimicrobial drug resistance.
Population mobility is a main factor in globalization of public health threats and risks, specifically distribution of antimicrobial drug-resistant organisms. Drug resistance is a major risk in healthcare settings and is emerging as a problem in community-acquired infections. Traditional health policy approaches have focused on diseases of global public health significance such as tuberculosis, yellow fever, and cholera; however, new diseases and resistant organisms challenge existing approaches. Clinical implications and health policy challenges associated with movement of persons across barriers permeable to products, pathogens, and toxins (e.g., geopolitical borders, patient care environments) are complex. Outcomes are complicated by high numbers of persons who move across disparate and diverse settings of disease threat and risk. Existing policies and processes lack design and capacity to prevent or mitigate adverse health outcomes. We propose an approach to global public health risk management that integrates population factors with effective and timely application of policies and processes.
MacPherson
Douglas W
DW
Migration Health Consultants Inc., Cheltenham, Ontario, Canada. douglaswmacpherson@migrationhealth.com
Gushulak
Brian D
BD
Baine
William B
WB
Bala
Shukal
S
Gubbins
Paul O
PO
Holtom
Paul
P
Segarra-Newnham
Marisel
M
D002353:Carrier State / Q000382:microbiology / Q000635:transmission; D021821:Communicable Diseases, Emerging / Q000188:drug therapy / Q000382:microbiology / Q000635:transmission*; D004352:Drug Resistance, Microbial; D054242:Emigrants and Immigrants; D004641:Emigration and Immigration; D006291:Health Policy; D006801:Humans; D038622:Internationality; D011634:Public Health; D012308:Risk Management; D014195:Travel