By Oliver Dyar
In the article we present two important dimensions of responsibility: responsible individual practices, and being responsible with how we choose to use antibiotics at the societal level. We contend that the discovery of antibiotics has created a broad global obligation: to ensure sustainable access to effective old and new antibiotics for all those who need them.
We discuss how these responsibilities are inter-related, and how efforts to achieve both should be coordinated. We raise an important ethical challenge which we feel has been inadequately addressed so far: are we prepared to on occasion provide less than optimal treatment for individuals to sustain the effectiveness of antibiotics for society as a whole?
We use the tragedy of the commons metaphor (see here) to illustrate the complexity involved in addressing these responsibilities in daily clinical practice, building on previous work by Levin (here), Baquero and Campos (here), and Foster and Grundmann (here). Drawing on our co-authors’ experiences in Uganda, India, China and France, we look at the real state of the antibiotics commons in the world today.
We conclude that we must head towards a global stewardship of antibiotics, and that there are promising recent developments that can support this, such as the upcoming UN General Assembly and the adoption of the Sustainable Development Goals.
The full text can be accessed here