Collecting evidence on access to essential antibiotics in refugee and migrant populations – World

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Health and migration evidence review highlights that equitable access and appropriate use of antibiotics for refugees and migrants is key to tackling antimicrobial resistance

More than 1.27 million people worldwide die each year from bacterial resistance to antimicrobials (AMR). Decades of misuse and overuse of antibiotics and other antimicrobials have made these drugs less effective in treating common infectious diseases, accelerating the emergence and spread of AMR.

The experiences of refugees and migrants in the country of origin, the migration path, entry and integration policies, and living and working conditions in the host country can increase the vulnerability of these populations to diseases. infections and questioning their ability to access antibiotics and treat illnesses appropriately.

The fourth report of the WHO Global Evidence Review on Health and Migration (GEHM), Capturing the evidence on access to essential antibiotics among refugees and migrants, brings together data on access to essential antibiotics for refugees and migrants and finds that access and use by these populations is heterogeneous and strongly influenced by the health systems of the host countries. While the extent of their access globally is unclear, the report highlights the most common health system barriers to antibiotic access and use in all regions: long wait times waiting to see a doctor, limited capacity of health services, high costs of health care, inappropriate prescription of antibiotics and lack of translated material or interpretation services.

Barriers to accessing health services and obtaining and using antibiotics can lead to unnecessary or incorrect use, often resulting in poorer health outcomes for users and the development of agents drug-resistant pathogens.

“Some studies show that refugees and migrants often resort to informal markets and self-medication to overcome obstacles in the health system in the host country,” said Dr. Santino Severoni, Director of the Health and Migration Program of the WHO. “Access to safe, effective, affordable and high-quality antibiotics for all, including refugees and migrants, is essential to promote the health of these populations and is essential to combat antimicrobial resistance and maintain the capacity to treat infections.

The report also identifies policies and non-health factors that impede access and appropriate use of antibiotics for refugees and migrants, such as previous unsatisfactory experiences with formal care and ease of informal access to antibiotics. Additionally, these populations may face stigma, fear of deportation due to migration status or language barriers, and be unable to access care due to lack of time or transportation and constraints. financial.

Based on the findings of the review, a series of policy considerations are proposed in five areas to improve access and appropriate use of antibiotics among refugees and migrants and help reverse the development of antimicrobial resistance in worldwide :

Build global governance for action against antimicrobial resistance by securing significant investments; align and integrate the WHO global action plans for refugees and migrants and for antimicrobial resistance into a coherent framework for concerted action; establish financial agreements in low- and middle-income country (LMIC) markets for equitable access and use of antimicrobials.

Improve global data collection by strengthening monitoring systems for data-driven and evidence-based policy solutions; support research with concerted and targeted funding to fill important knowledge gaps. Address national barriers to seeking formal care by facilitating access to care by improving language accessibility and health literacy for refugees and migrants; monitor and support the provision of migrant and refugee-friendly cultural competency training for health personnel; improving the knowledge of migrants and refugees about antibiotics through community initiatives.

Address national-level barriers to formal care utilization by removing systemic barriers to care based on legal status; ensure that quality-assured essential antibiotics are affordable; improve knowledge and recording of the rights to care of vulnerable populations and health care providers; avoid policies that restrict access to antibiotics for vulnerable populations.

Overcome national-level barriers to adequate and quality care by ensuring access to point-of-care diagnostic tools for optimal case management in vulnerable populations.

Equitable access and appropriate use of existing and new antimicrobial medicines for all, including refugees and migrants, is a basic human right and is vital for an effective global public health response to the ever-increasing range of infections caused by bacteria, parasites, viruses and fungi.

“We need to focus on vulnerable individuals and populations while addressing AMR. Equitable access to infection prevention measures, timely and quality diagnostic services and quality-assured antibiotics are essential elements of the global response to AMR,” said Catharina Van Weezenbeek, Director, SPC/ AMR.

“We need to strengthen our evidence on the burden and impact of antimicrobial resistance on refugee and migrant populations, and then help refine national regulations and policies as well as global guidelines. We look forward to working closely with the Health and Migration program on these activities.

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