Payers such as governments, church-based healthcare systems, or private insurers can each signal providers as to how to use antibiotics. These signals can take the form of financial or non-financial incentives. Pay-for-performance approaches can influence provider behavior, just as some incentives also pay providers to prescribe more antibiotics. Significant work still needs to be undertaken to realign such incentives to encourage rational use of antibiotics.
Governments can adopt National Action Plans on antimicrobial resistance, as called for under the Global Action Plan on Antimicrobial Resistance. A key component of these plans focuses on the healthcare delivery system, but not in isolation from other sectoral contributions. Governments can support, with both technical and financial resources, the implementation of efforts to tackle AMR; establish a regulatory framework and put expert guidelines in place; and mandate collection of data to ensure effective monitoring for accountability.
Universities and professional schools training future physicians, nurses, pharmacists and other healthcare professionals can include AMR as part of their curricula and can make this as part of what defines professional competency. Such institutions also can conduct research and pilot new interventions that might address AMR in its local context.
Non-governmental organizations, from professional societies to consumer groups, play a critical role in supporting effective regulation, credentialing, and certification of key actors, from healthcare providers to industry, to engage in more rational and responsible use of antibiotics. These groups can also mobilize public and policymaker awareness of AMR.
DRUG MANUFACTURERS / INDUSTRY
Industry can encourage rational use of antibiotics by complying with appropriate package dosing and labeling, making full treatment courses affordable, and not mispromoting the use of antibiotics where not indicated. Authentication technologies (such as scratch-off codes that verify the integrity of the package when texted back) can help with pharmacovigilance efforts.
Wholesalers are responsible for ensuring the integrity, quality, and reliability of the supply chain of antibiotics. Along with drug manufacturers, they contribute importantly to the affordability and the availability of antibiotics. Effective inventory management can prevent stockouts, and efficient procurement practices, affordable pricing.