CDDEP Director Ramanan Laxminarayan was a featured contributor this week in a New York Times “Room for Debate” discussion on antibiotic resistance. Seven contributors, including researchers, doctors and experts from the public sector, answered the question “How we can avoid a future where antibiotics are no longer useful?”

Laxminarayan argues that coping with antibiotic resistance is particularly challenging for low- and middle-income countries, where there are few regulations on the sale of antibiotics and medical institutions rely on pharmaceutical sales for income. As incomes rise in countries like India and China, antibiotics are becoming more accessible than ever, with people able to purchase the drugs at local shops and pharmacies without prescriptions.

“The paradox is that many people who will die from resistant infections live in countries where antibiotic use was low in the past, in the same way that climate change can disproportionately affect nations that may have done little to cause it,” he writes.

To combat the problem, wealthier countries will need to reduce their own use of antibiotics, setting an example for lower-income countries. Additionally, Laxminarayan argues that a global agreement treating antibiotic effectiveness as a global public good would allow for the creation of better resistance surveillance mechanisms, more advanced research, and the coordination of global efforts against resistance.

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