Accelerating the Development and Uptake of Rapid Diagnostics to Address Antibiotic Resistance Proceedings of a Workshop (2023) / Chapter Skim
Currently Skimming:
5 Health Equity Considerations
5 Health Equity Considerations
Pages 49-62
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 49... ...
• To be sustainable, systems for detecting and addressing AMR should be integrated into routine health systems so that they offer regular value to patients, clinicians, and the public health enterprise. (Bausch)
|
From page 50... ...
Mallory was diagnosed with cystic fibrosis at the age of three. She had a happy childhood with no significant health challenges until she was colonized by Burkholderia cenocepacia, an opportunistic bacteria that commonly infects immunocompromised patients, at the age of 12.
|
From page 51... ...
. The Lancet published the largest study to date about superbugs at the same time the New York Times referred to Salt in My Soul as an awareness raising tool about the possibilities of bacterial phages (Antimicrobial Resistance Collaborators, 2022; Kenigsberg, 2022)
|
From page 52... ...
Elevating AMR diagnostics to research status under the Common Rule, said Evans, could open opportunities for product development pipelines and standard setting for treating drug-resistant bacterial infections. Diagnostic data and sample sharing In past public health efforts, there has been a lack of consistent attention and commitment to domestic and international data and sample sharing, said Evans.
|
From page 53... ...
. Data and sample sharing are core concerns when it comes to global health equity and justice, said Evans, and ensuring access to results and samples is critical for controlling infectious disease and AMR.
|
From page 54... ...
Some of these behaviors, said Pettigrew, are highly stigmatized, putting individuals at extra risk and influencing how they interact with the public health and healthcare system. According to Pettigrew, in order to address health inequities, the first step is to identify groups that are at risk and to better understand the drivers and mechanisms behind these inequities.
|
From page 55... ...
In 1993, the NIH was given explicit authority to direct investigators of funded research to improve representation in trials with respect to gender, race, and ethnicity, but these policies do not apply to private industry. The FDA requires sponsors of new drug applications to present efficacy and safety data by gender, age, and racial subgroups, and in 2014, the FDA published an Action Plan for encouraging more inclusive trial participation.1 However, after decades of voluntary and aspirational initiatives, there remains a lack of diverse representation in clinical trials, said Pettigrew.
|
From page 56... ...
Even when diagnostic technology is effective and affordable, said So, there can still be unintended consequences from implementing it. For example, a clinical algorithm applied by healthcare workers to manage patients presenting with fever used a combination of respiratory rate and rapid diagnostic tests for malaria to determine if antibiotic treatment, not just antimalarial treatment, were needed (Mukanga et al., 2012)
|
From page 57... ...
So shared the details of two innovations that were motivated by equity considerations, both of which were supported by Doctors without Borders (Médecins Sans Frontières or MSF)
|
From page 58... ...
First, a systems perspective would enable strategic consideration of how to nurture dual markets in high-income countries and resource-limited markets that support equitable and sustainable access to diagnostics. For example, diagnostic platforms could serve to monitor and track emerging infections in health care settings as well as monitor prevalence of pathogens in wastewater.
|
From page 59... ...
For example, a study published in The Lancet said that 1.27 million people per year are dying of drug resistant bacterial infections, and the World Bank estimates that if AMR goes unchecked, 24 million people will be forced into extreme poverty by 2030 (Antimicrobial Resistance Collaborators, 2022; World Bank, 2017)
|
From page 60... ...
"We all approach the world and research problems and challenges with our own lens based on our own experiences," so if there are not enough diverse investigators running trials, there will not be diverse trial participants. In terms of barriers to trial participation, Pettigrew said that investigators need to consider issues such as access to the trial site, reimbursement for travel, and taking time off work.
|
From page 61... ...
Speaking from a marketing perspective, Shader Smith posited that if a popular and accessible platform, such as the Today Show, had an amputee, a cystic fibrosis patient, and a caregiver of a deceased patient share their stories, this could be a powerful way to educate and reach people. Shader Smith pointed out the need for a global marketing plan that includes people from outside of the insulated community of existing AMR experts and stakeholders.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.