Beyond high cost: Pharmaceutic low-resource setting barriers to antibacterial access

Antimicrobial resistance (AMR) is a growing threat, particularly on the African continent, where high infectious disease burdens and low access to effective medicines exacerbate the problem. The chemistry and formulation of antibacterials, particularly orally active, broad-spectrum ‘Access’ antibacterials, have been a critical issue in enhancing access for African patients. These antibacterials are particularly useful in hot, humid African settings with weak supply chains, where optimal storage conditions require air-conditioning and long durations between shipments. However, these antimicrobials can be used by community health workers, overcoming the limitations of fewer options for those who cannot or will not be admitted to the hospital. Additionally, the activity spectrum of these antimicrobials is crucial, as the deeper diagnostic information essential for rational use of narrow-spectrum antimicrobials can make them inaccessible without laboratory infrastructure or point-of-care testing. Therefore, integrated development of accessible antimicrobials is needed to address the barriers to access for African patients.