title: Maximising access to achieve appropriate human antimicrobial use in low-income and middle-income countries.
abstract: Access to quality-assured antimicrobials is regarded as part of the human right to health, yet universal access is often undermined in low-income and middle-income countries. Lack of access to the instruments necessary to make the correct diagnosis and prescribe antimicrobials appropriately, in addition to weak health systems, heightens the challenge faced by prescribers. Evidence-based interventions in community and health-care settings can increase access to appropriately prescribed antimicrobials. The key global enablers of sustainable financing, governance, and leadership will be necessary to achieve access while preventing excess antimicrobial use.
authors.affiliation: Division of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa. Electronic address: marc.mendelson@uct.ac.za.
authors.forename: Marc
authors.initials: M
authors.lastname: Mendelson
authors.affiliation: Norwegian Institute of Public Health, Oslo, Norway; Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Global Health and Population, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA.
authors.forename: John-Arne
authors.initials: JA
authors.lastname: Røttingen
authors.affiliation: Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway.
authors.forename: Unni
authors.initials: U
authors.lastname: Gopinathan
authors.affiliation: Zambia Center for Applied Health Research and Development, Lusaka, Zambia; Center for Global Health and Development, Boston University School of Public Health, Boston, MA, USA; Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, MA, USA.
authors.forename: Davidson H
authors.initials: DH
authors.lastname: Hamer
authors.affiliation: Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, National Hospital for Tropical Diseases, Hanoi, Vietnam; Nuffield Department of Clinical Medicine, Centre for Tropical Diseases, Oxford, UK.
authors.forename: Heiman
authors.initials: H
authors.lastname: Wertheim
authors.affiliation: Oxford University Clinical Research Unit-Nepal, Kathmandu, Nepal.
authors.forename: Buddha
authors.initials: B
authors.lastname: Basnyat
authors.affiliation: Nuffield Department of Primary Care Health Sciences, Oxford University, Oxford, UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: Butler
authors.affiliation: Departments of Learning, Informatics, Management, Ethics and Public Health Sciences, Karolinska Institute, Stockholm, Sweden.
authors.forename: Göran
authors.initials: G
authors.lastname: Tomson
authors.affiliation: Access Campaign, Médecins Sans Frontières, Geneva, Switzerland.
authors.forename: Manica
authors.initials: M
authors.lastname: Balasegaram
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy; D003695:Delivery of Health Care; D003906:Developing Countries; D003955:Diagnostic Tests, Routine; D004352:Drug Resistance, Microbial; D016568:Drugs, Generic; D055317:Evidence-Based Practice; D005381:Financing, Organized; D006297:Health Services Accessibility; D006801:Humans; D057970:Inappropriate Prescribing; D019095:Point-of-Care Systems; D017410:Practice Guidelines as Topic; D011322:Primary Prevention; D011786:Quality Control; D014611:Vaccination
chemical_list: D000900:Anti-Bacterial Agents; D016568:Drugs, Generic