Challenges to Accessing Newer Antibiotics for Multidrug-resistant Bacterial Infections in Asia: A Literature Review of Multi-Stakeholder Perspectives.

Abstract

Asia faces significant barriers to accessing newer antibiotics despite a high burden of antimicrobial resistance. We conducted a literature review to identify key gaps and challenges in access to newer antibiotics in Asian countries. Peer-reviewed and gray literature from January 2010 to October 2024 were searched for articles discussing access to Food and Drug Administration (FDA)-approved antibiotics post-2010 with an Asian perspective. A total of 134 articles were reviewed. Key challenges spanned 7 main stakeholders: pharmaceutical industries, drug regulatory agencies, health technology assessment agencies, funders/nongovernmental organizations, healthcare practitioners, patient advocates, and ministries of health/policymakers. These challenges included limited and fragmented epidemiological data, insufficient health economic assessments, manufacturing constraints, complex regulatory frameworks, inefficient distribution systems, poor affordability in low-resource settings, and weak governance structures. These findings underscore the urgent need for a deeper understanding of stakeholder- and context-specific perspectives to address critical gaps and improve antibiotic access in the region.