WHO Global Evidence Review on Health and Migration

In News

• The fourth report of the WHO Global Evidence Review on Health and Migration was recently released.

Report Highlights

• Antimicrobial resistance in Refugees and migrant population:
  • Refugees and migrant populations are particularly vulnerable to antimicrobial resistance (AMR) due to poor access to healthcare in the backdrop of an increased probability of infections, according to the report.
  • The healthcare needs of these populations are heterogenous and depend heavily on host countries’ capacity, noted the report.
• Issue:
  • More than 1.27 million people across the world die every year due to AMR.
  • International refugees and migrant populations have seen an increase throughout this century, accounting for 281 million, or about 3.5 percent of the global population, in 2020.
• Causes highlighted in the report:
  • Primary cause:
    • While AMR is ultimately inevitable, prolonged drug use will make the body resistant to it. 
    • The progression has been accelerated by years of misuse and overuse. But this is not the only indicator on the rise.
  • Migrants specific cause:
    • “The conditions under which refugees and migrants leave their countries of origin and transit to their destination countries may lead to increased infections, as well as to disruptions and barriers to healthcare access,” the report noted.
  • Other causes acting as key barriers:
    • Long waiting times to consult a doctor, limited capacity of health services, 
    • High healthcare costs, 
    • Inappropriate prescription of antibiotics and 
    • Lack of translated materials or interpretation services 
    • These are the key barriers to accessing and using antibiotics across the world, the analysis revealed. 
    • This has triggered many to resort to unsafe means to meet their healthcare needs.
• Evidence:
  • The evidence is assessed based on the literature available on four key indicators — 
    • Access, 
    • Appropriate use, 
    • Barriers to access and use and 
    • Interventions to improve access and use. 
    • However, data for the first two remain scarce, coming in largely from high-income countries and practically non-existent for low and middle-income countries.

Challenges Posed by AMR

• Antibiotic resistance is emerging as a threat to the successful treatment of infectious diseases, organ transplantation, cancer chemotherapy and major surgeries.
• The issue of AMR causes out-of-pocket expenditure on health care, especially on medicines. The use of high-order drugs or second-line expensive antibiotics pushes treatment costs high.
• Neonates and the elderly both are prone to infections and are vulnerable.

India’s Initiative

• Doctor’s prescription:
  • To prevent the Over the counter sales of antibiotics, the central drug standard control organisation (CDSO) prohibits medical stores from selling 24 key antibiotics without a doctor’s prescription.
• India’s Red Line campaign: 
  • It demands that prescription-only antibiotics be marked with a red line, to discourage the over-the-counter sale of antibiotics– is a step forward.
• National Health Policy, 2017:
  • The policy terms antimicrobial resistance as one of the key healthcare issues and prioritises the development of guidelines regarding antibiotic use and check on restricting the growth of antibiotics.
• The National Action Plan on Antimicrobial Resistance (NAP-AMR) 2017:
  • The action plan has assigned coordinated tasks to multiple government agencies involving health, education, environment, and livestock to change prescription practices and consumer behaviour and to scale up infection control and antimicrobial surveillance.
• Limiting antibiotics in food products:
  • FSSAI has set certain guidelines limiting the antibiotics in food products such as fish and honey.

Way ahead

• Till now, there are two major possible solutions to combat the AMR menace:
  • Discovery of new drugs, before the emergence of resistance in germs; and prudent use of available antibiotics.
    • The discovery of a new drug is an expensive and unpredictable process, the estimated cost for developing a new antibiotic exceeds $1 billion.
  • The second solution is the best possible solution i.e. to use the available antibiotics carefully to ensure their efficacy for as long as possible.
• Maintaining the ability to treat serious infections requires a balance between equitable access to and appropriate use of existing and new antimicrobial medicines for all.

Source: TH