Facing the Pandemic of Antimicrobial Resistance: Current Actions and Future Challenges in Antibiotic Stewardship, Access, and Innovation in Brazil

While some high-income countries are considering specific actions to address the growing burden of antimicrobial resistance (AMR), efforts among low- and middle-income countries are less common. This case study analyzes current efforts in Brazil, a middle-income country, to improve antibiotic stewardship, access, and innovation.

We carried out a desk review of current active efforts, national policies, and procurement processes within the Brazilian Unified Health System (SUS) related to antibiotic access, stewardship, and innovation. We complemented this analysis with 11 expert interviews. All interviewees are currently working within the Brazilian health sector and have direct knowledge of and/or decision-making authority on AMR-related initiatives.

Our desk review and interviews highlighted the importance of three institutions. First, ANVISA, the national health regulatory authority, oversees new drug approvals and is responsible for health surveillance. Second, the Drug Market Regulation Chamber (CMED) regulates drug pricing in Brazil. And third, the Ministry of Health (MoH) manages public health policies and purchases highly specialized health products for SUS.