On September 19, 2022, the WHO published the fourth report in the Global Evidence Review on Health and Migration (GEHM) series with a focus on Antimicrobial Resistance. The report captures the evidence on access to essential antibiotics in refugee and migrant populations, gathers evidence on the access to essential antibiotics for refugees and migrants, and finds that access to and use by these populations is heterogeneous and significantly influenced by the health systems of the host countries.
While AMR is a global challenge, it is clear that international refugee and migrant populations may be particularly vulnerable to rising AMR. Migrant and refugee experiences ranging from their country of origin, migration journey, entry and integration policies, and living and working conditions in the host country can increase their vulnerability to infectious diseases, challenge their ability to access antibiotics, and create barriers in accessing proper health services. This may result in unnecessary or incorrect use of antibiotics, which often leads to poorer health outcomes for the users and further development of drug-resistant pathogens.
The report puts forward a series of policy considerations in five different areas that could help improve access to and appropriate use of antibiotics in refugee and migrant populations:
Build global governance for AMR action by ensuring significant investment; aligning and integrating WHO global action plans for refugees and migrants and for AMR into a coherent framework for concerted action; establishing financial arrangements in low- and middle-income countries (LMIC) markets for equitable antimicrobial access and use.
Improve global data collection by strengthening surveillance systems for data-driven, evidence-informed policy solutions; supporting research through concerted and targeted funding to fill substantial knowledge gaps.
Tackle national-level barriers to seeking formal care by facilitating access to care by improving language accessibility and health literacy for refugees and migrants; monitoring and supporting the provision of migrant- and refugee-sensitive cultural competency training for health care personnel; improving migrants’ and refugees’ knowledge of antibiotics through community-based initiatives.
Tackle national-level barriers to utilizing formal care by removing systemic barriers to care based on legal status; ensuring that essential, quality-assured antibiotics are affordable; improving knowledge of and registration for entitlements to care in vulnerable populations and health care providers; avoiding policies that restrict antibiotic access for vulnerable populations.
Overcome barriers at national level to adequate and quality care by ensuring access to point-of-care diagnostic tools for optimal case management in vulnerable populations.
The report was possible thanks to collaboration between WHO’s Health and Migration Programme (PHM), the Department of Surveillance, Prevention and Control (SPC) of the Antimicrobial Resistance Division (AMR), Dr. Susan Rogers Van Katwyk and a team of GSL researchers including Policy Advisor Michèle Palkovits, Senior Analyst Ranjana Nagi, Research Fellow Andrea Morales Caceres and Director Steven Hoffman.
Access the full report here.