CID Archive: Events Archive: Past Conferences
International Workshop on Antibiotic Resistance: Global Policies and Options
28 February 2000
Center for International
Development, Harvard University
Overview | Background | Final Report
A workshop on "Antibiotic Resistance: Global Policies and Options" was
hosted by the Center for International Development at Harvard University on
28 February 2000 to assess the current state and future directions of
policy responses to the global problem of antibiotic resistance.
The objectives of the workshop were to:
Papers presented at this workshop dealt with institutional and policy issues related to:
Two online discussions were conducted in conjunction with the workshop. The first discussion was planned for the month prior to the workshop and the second one was held following the workshop. Details of these online discussions were posted on the original workshop web site.
Overview | Background | Final Report
The increasing failure of antibiotics to treat commonly curable infectious diseases represents one of the most significant challenges to the medical profession in modern times. This failure is caused by growing bacterial resistance to antibiotics is a direct outcome of the selective advantage provided by the use of antibiotics to resistant bacteria. In particular, the increase in antibiotic resistance associated with hospital-acquired infections has resulted in increased morbidity and mortality, longer hospital stays and more frequent hospital and ICU readmission. Consequently, the cost of treating a drug resistant bacterial infection has been reported to be much greater than the cost of treating a susceptible infection.
Although the potential for resistance was recognized as early as in the 1940s when antibiotics were first introduced, significant increases in resistance have been noted only in the last two decades. The problem has exacerbated by the absence of new antibiotics over this time period. In fact, the last major antimicrobial class to be discovered, carbapenems, was first identified nearly two decades ago.
It is frequently recognized that the widespread use of antibiotics, both in medicine and in agriculture represents an important reason for the increase in antibiotic resistance. Subtherapeutic use of antibiotics, and the failure of patients to complete a full course of antibiotic treatment in outpatient settings are also believed to be contributory. Although there is consensus on the need to reduce antibiotic use, and to use them more carefully, there is less clarity on the nature of policy mechanisms using which this objective may be attained. Consequently, international efforts to tackle the antibiotic resistance have been slow to emerge and are for the most part, restricted to surveillance of antibiotic resistance.
Fundamentally, the antibiotic resistance problem arises from the absence of economic incentives for individuals to take into account the negative impact of their use of antibiotics on social welfare. Therefore any solution to the problem of antibiotic resistance requires not only that it be medically sound, but also that it be compatible with incentives faced by patients, doctors, pharmaceutical firms, and public health regulatory agencies. To this end, an interdisciplinary workshop comprising physicians, epidemiologists, economists, sociologists, legal professionals, and policy makers would facilitate the search for an incentive-compatible solution to the global problem of antimicrobial resistance.
Overview | Background | Final Report
This report was prepared by Julia Aledort, Ramanan Laxminarayan (Workshop Organizer), David Howard and Erica Seiguer. Additional assistance was provided by Susanne Weldon.
Overview |
Background |
Final
Report
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2007 by the President and Fellows of Harvard College.
Last revised 31 October 2007