School of Health Policy and Management, York University, Toronto, Ontario, Canada.
Int J Health Serv. 2021 Oct;51(4):521-530. doi: 10.1177/0020731420949823. Epub 2020 Aug 16.
The urgent public health threat of antimicrobial resistance (AMR) has received much attention from the world's most important health agencies and national governmental organizations. However, despite large investments being allocated to strategizing national and international plans for addressing this public health problem, the incidence of untreatable, antimicrobial-resistant diseases continues to rise in many nations. To avoid returning to a society in which common infections once again become deadly, one must consider the often-ignored root causes driving inappropriate behaviors relating to antimicrobial use, such as the history of antimicrobial drug development, the effects of commodifying health-related services, and the rise in social inequalities. By employing the lens of political economy to analyze the phenomenon of AMR on national and international scales, it is found that the acceptance of neoliberalism as a governing ideology by authorities is hindering our ability to globally combat AMR through the depoliticization of issues that require political intervention to stimulate change. Differences in level of AMR and approaches to pharmaceutical governance between social democratic and liberal welfare states provide validity to this hypothesis.
抗菌药物耐药性（AMR）这一紧迫的公共卫生威胁已经引起了世界上最重要的卫生机构和各国政府组织的高度关注。然而，尽管投入了大量资金来制定解决这一公共卫生问题的国家和国际计划，但在许多国家，无法治疗的、具有抗药性的疾病的发病率仍在继续上升。为了避免回到一个常见感染再次致命的社会，人们必须考虑到经常被忽视的导致与抗菌药物使用不当的根本原因，例如抗菌药物开发的历史、将与健康相关的服务商品化的影响，以及社会不平等现象的加剧。通过在国家和国际层面上运用政治经济学的视角来分析 AMR 现象，可以发现，当局接受新自由主义作为一种治理理念，通过将需要政治干预以刺激变革的问题非政治化，阻碍了我们通过全球合作来对抗 AMR 的能力。社会民主和自由福利国家在 AMR 水平和药物治理方法上的差异为这一假设提供了依据。
