Submission ID 131768
| Issue/Objective | Antimicrobial resistance (AMR) is exacerbated by both lack of novel antibiotic development and inequitable access to existing and new antibiotics. Recent policy approaches have focused on identifying effective 'push' (e.g., grants, tax credits) and 'pull' (e.g., market entry rewards, subscription models) mechanisms to provide incentives for novel antimicrobial drug development. However, there has been limited analysis of how push/pull incentives are framed in global health, how framing influences what solutions are offered to stimulate antibiotic drug development, and how to reframe incentives to ensure equitable antibiotic development and access. |
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| Methodology/Approach | We conducted a scoping review of peer reviewed and grey literature (2000-2025) focused on the framing of problems and solutions related to antibiotic drug development and access, and lessons for the design or reframing of solutions. We conducted thematic analysis based on a deductive-inductive approach, compiling a list of existing global health frames. Such frames are ways of defining and understanding global health problems, including AMR. Certain framings are more likely to shape decision-making and policies in ways that promote equitable outcomes. We assessed the prevalence of equity considerations under different framings. |
| Results | Public interest framings, which consider the importance of governance, coordination, antibiotic stewardship and patient access; economic framings, which consider profitability; and scientific framings, concerned with the scientific process, are dominant in the literature. Equity considerations are present under public interest framings that highlight the need to align the development of new antibiotics with public health needs and emphasize access-related challenges for novel antibiotics, especially in low- and middle-income countries. They are also emphasized under development framings, which focus on the importance of building R&D and health systems capacities in LMICs, as well as in human rights framings, which describe access to effective medicines as a fundamental right. |
| Discussion/Conclusion | An equitable innovation incentive ecosystem must: address issues related to multiple frames, take an approach that considers both investments in R&D and access to new and existing antibiotics; and requires a coordinated systems approach that moves beyond nationally bounded incentive mechanisms, including regulatory measures spanning regional and global health systems, and facilitates Global South leadership in decision-making. |
| Presenters and Affiliations | Lauren Wallace Global Strategy Lab Heather Kinsey The Regional Municipality of York Kayla Strong Global Strategy Lab Geneviève Boily-Larouche Global Strategy Lab Tracey Wagner-Rizvi Global Strategy Lab Mathieu Poirier Global Strategy Lab Arne Ruckert Global Strategy Lab |
