151. Containing Global Antibiotic Resistance: Ethical Drug Promotion in the Developing World
- Author
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Bryn Williams-Jones, Béatrice Doizé, Catherine Olivier, and Vural Ozdemir
- Subjects
Economic growth ,medicine.medical_specialty ,business.industry ,media_common.quotation_subject ,Public health ,Public policy ,Developing country ,Health intervention ,Globalization ,Promotion (rank) ,Urbanization ,Medicine ,business ,Social responsibility ,media_common - Abstract
The introduction of antimicrobial agents was a breakthrough health intervention that helped save millions of lives around the world and that provided a sense of control on the part of clinicians over host–pathogen interactions. Yet despite the concrete advances in prevention and treatment of infectious diseases, there has been a parallel surge in resistance to antimicrobials that is seriously compromising the gains made over the past century. Acknowledging the underlying mechanisms such as inappropriate use of antibiotics in humans and the agricultural applications of antibiotics for growth promotion and prophylaxis is a first and essential step to contain global antimicrobial resistance. However, it is also critical to consider in parallel the broad social, economic and political drivers and ethical significance of antimicrobial promotion in developing countries. Moreover, these socio-ethical factors constitute tangible targets against which public policy interventions can be developed to remedy growing concerns over the spread of antimicrobial resistance. In this chapter, we focus on drug promotion practices in the developing world that have important repercussions on physician prescribing habits, antimicrobial use and development of resistance. Other social factors that are endemic in developing countries – such as inadequate resources in health and education systems – can amplify erratic or suboptimal drug use. The public health consequences of, and ethical responsibilities associated with, drug promotion are substantially larger when viewed through the prism of the realities faced by persons living in developing countries. In our world of increasing urbanization and globalization, the actions of pharmaceutical companies have a global impact. Thus, their social responsibilities extend beyond developing medications for the populations of the developing world, to include socio-ethical and public health consideration for populations worldwide. Focusing on the fact that ‘what happens in the developing world does not stay in the developing world’, we propose that ethical considerations should be included as an integral part of the framework in the evaluation of appropriateness of drug promotion practices.
- Published
- 2009
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