A policy brief published yesterday by the European Observatory on Health Systems and Policies suggests antimicrobial resistance (AMR) policies need to take socioeconomic and sociocultural factors into account.
The brief notes that while efforts to understand AMR have focused on the biomedical model, interactions between socioeconomic and sociocultural determinants of health and AMR, particularly in low- and middle-income countries, have not been studied extensively. Among the factors the authors highlight are gender, living situations, healthcare access, educational access, poor governance, mobility, conflict, and climate change.
Although how these factors contribute to the spread of AMR are complex, the authors say that understanding them could inform development of interventions. Such interventions could address, for example, why women are more likely than men to experience exposure to drug-resistant infections and be prescribed antibiotics, why people in urban and overcrowded environments are associated with a higher risk of AMR, how limited access to healthcare can result in more inappropriate antibiotic use, and how human mobility and conflict can lead to the introduction and spread of new strains of drug-resistant organisms.
"Policy that understands these and the way they interact with one another will be more likely to achieve its aims," the authors write.
A new policy framework
The brief suggests that a policy framework to respond to these socioeconomic and sociocultural factors should focus on antimicrobial stewardship, infection prevention and control, equitable access to diagnostics and effective treatments, and increased investment in incentives to stimulate research and development into new treatments. It should also be people-centered, multifactoral, and evidence-based and emphasize effective governance.
"There is increasing evidence of the critical role that socioeconomic and sociocultural factors play in driving AMR, shaping the health and economic impacts of AMR, and influencing the effectiveness of innovations and progress to tackle AMR at the individual, health system and societal level," the authors write. "It is essential that AMR policy takes these socioeconomic drivers and impacts into account moving forward."
