A Report of the Center for Global Development's Drug Resistance Working Group

Authors: Editors: Rachel Nugent, Emma Back and Alexandra Beith

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In an increasingly interconnected world, problems with drug resistance have moved from the patient's bedside to threaten global public health. Drug resistance has dramatically increased the costs of fighting tuberculosis (TB) and malaria, has slowed gains against childhood dysentery and pneumonia, and threatens to undermine the push to treat people living with HIV/AIDS effectively. Global health funders and development agencies have cause to worry about whether their investments in access to drugs, and global health programming more broadly, are being undone by the relentless advance of drug resistance.

Drug resistance is an extremely serious problem that is today undermining effective health care for millions of people and threatens to grow worse, yet it doesn't receive serious attention. On a technical level, this is because drug efficacy is a common property resource: one that is difficult to bar people from using, but that does run out if we overuse it. We all want to believe that the drugs we rely upon will keep working no matter how much we use them or misuse them. Further, many actors make deci- sions that determine the trajectory of drug resistance that impose invisible costs to society, thereby lulling us into complacency. On a human level, it is hard to see that people are dying from drug resistance, but they are. As with climate change, we now understand the science of drug resistance well enough to act, but the policy response has eluded us.

The Center for Global Development's global health work focuses on issues where donors can benefit from expert techni- cal advice and detailed analysis to guide decisions about resource investments. This report is an example. The Drug Resistance Working Groupi was convened in late 2007 to identify practical and feasible ways for donors, multilateral organizations, non- governmental organizations, and private companies to prevent or contain resistance to drugs for infectious diseases affecting developing countries.

The highly accomplished members of the Working Group came to this task with a wide range of specialized knowledge. They acknowledged the difficulties of tackling drug resistance from a perch in Washington, Boston, London, and even Accra, but insisted that the recommendations include both global actions and local solutions that hold the potential to alter the culture of how we use medicines worldwide. In the course of their discus- sions, Working Group members carefully examined the common drivers of drug resistance that plague treatment efforts for many infectious diseases, particularly in developing countries. As a result, their recommendations emphasize common, cross-disease approaches, rather than vertical, disease-specific actions.

The full report is open accessible at the Centre for Global Development Website.

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