article · Health Science Reports
Antimicrobial resistance and the COVID-19 pandemic have created a dual crisis that presents severe challenges for healthcare systems in low- and middle-income countries. A comprehensive survey of literature published between January 2020 and January 2023 reveals that the pandemic exacerbated the drivers of antibiotic resistance. These drivers include limited healthcare capabilities, fragile policy frameworks, disrupted antibiotic supply chains, and an elevated incidence of healthcare-associated infections. Addressing these intertwined issues requires a coordinated response across multiple stakeholders. Priorities include strengthening national health systems, upgrading infection prevention and control practices, and establishing cohesive regulatory frameworks. Furthermore, managing this burden requires expanding regional collaborations, securing sustainable access to clean water and sanitation, and developing accessible therapeutic alternatives, including early-stage interest in emerging approaches such as phage therapy.
The combination of the COVID-19 pandemic and antimicrobial resistance threatens public health progress in low- and middle-income countries. Ineffective antibiotics make common infections harder to treat, driving up healthcare costs and mortality. Recognising how systemic disruptions accelerate resistance enables policymakers, health authorities, and international funders to implement targeted interventions, secure supply chains, and build more resilient healthcare infrastructure.
The work highlights an application pathway centered on research, development, and regulatory planning for alternative therapeutics such as phage therapy, targeted at healthcare providers and developers in low- and middle-income regions. Because this is a broad literature review calling for funding, capability building, and long-term planning, these therapeutic opportunities appear to be at an early research stage rather than near commercial deployment.
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Background and Aims: Antimicrobial resistance (AMR), a global health crisis of mounting urgency, has been further complicated by the ongoing COVID-19 pandemic. The intricate relationship between these two phenomena is especially pronounced in low- and middle-income countries (LMICs) due to the distinct obstacles encountered by their healthcare systems and policy structures. This study aims to explore the complex challenges arising from the coexistence of these two crises in LMICs and proffer specific recommendations for holistic management. Methods: An exhaustive bibliographic survey was executed, employing search queries in specialized databases such as PubMed, SCOPUS, and Web of Science's SCI-EXPANDED index. The timeframe for the literature search extended from January 2020 to January 2023. The search strategy employed key terms including antibiotic resistance, AMR, COVID-19 pandemic, low- and middle-income countries, SARS-CoV-2, and LMICs. Results: The pandemic has aggravated various drivers of AMR in LMICs, including limited capabilities, weak frameworks, and socioeconomic factors. New challenges have emerged, such as disruptions in the antibiotic supply chain and an increased risk of healthcare-associated infections. The interaction between these drivers presents a complex problem that demands a coordinated response. Specific recommendations include strengthening health systems, funding research and innovation, and enhancing infection prevention control measures. Conclusion: The coexistence of AMR and the COVID-19 pandemic in LMICs demands an integrated approach involving multiple stakeholders. Emphasis must be placed on constructing aligned regulatory frameworks, nurturing regional collaborations, and focusing on accessible therapeutic options. The study underscores the necessity for actionable strategies to achieve sustainable access to clean water and sanitation and also highlights the importance of long-term planning, funding, and specialized expertise in emerging modalities like phage therapy.
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DOI: 10.1002/hsr2.1566
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