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Global governance and market failures mean that it is not possible to ensure access to antimicrobial medicines of sustainable effectiveness. Many people work to overcome these failures, but their institutions and initiatives are insufficiently coordinated, led and financed. Options for promoting global collective action on antimicrobial access and effectiveness include building institutions, crafting incentives and mobilizing interests. No single option is sufficient to tackle all the challenges associated with antimicrobial resistance. Promising institutional options include monitored milestones and an inter-agency taskforce. A global pooled fund could be used to craft incentives and a special representative nominated as an interest mobilizer. There are three policy components to the problem of antimicrobials--ensuring access, conservation and innovation. To address all three components, the right mix of options needs to be matched with an effective forum and may need to be supported by an international legal framework. Les dysfonctionnements de la gouvernance et du marche a l'echelle mondiale se traduisent par une impossibilite de garantir l'acces a des medicaments antimicrobiens durablement efficaces. De nombreuses personnes s'emploient a pallier ces dysfonctionnements, mais leurs institutions et leurs initiatives manquent de coordination, de direction et de moyens financiers. La creation d'institutions, l'elaboration de mesures d'incitation et la mobilisation des parties interessees font partie des options possibles pour promouvoir une action collective mondiale sur l'acces aux antimicrobiens et sur leur efficacite. Aucune option isolee ne suffira a venir a bout de tous les problemes associes a la resistance aux antimicrobiens. Parmi les options institutionnelles prometteuses, il convient de mentionner le suivi des etapes importantes et une equipe speciale interorganisations. Des fonds mis en commun a l'echelle mondiale pourraient etre utilises pour elaborer des mesures d'incitation et un representant special pourrait etre charge de mobiliser les parties interessees. Le probleme des antimicrobiens comporte trois aspects strategiques: garantir l'acces, la conservation et l'innovation. Pour agir a l'egard de ces trois aspects, il est necessaire d'associer les options, harmonieusement combinees, a une structure efficace et, peut-etre, de les inscrire dans un cadre juridique international. Los fracasos de gobernanza mundial y de los mercados significan que no es posible garantizar el acceso a medicamentos antimicrobianos de efectividad sostenible. Muchas personas trabajan para solucionar estos problemas, pero sus Instituciones e iniciativas no estan lo suficientemente coordinadas, guiadas y financiadas. Las opciones para promocionar una accion colectiva global en cuanto al acceso a los antimicrobianos y la efectividad incluyen la creacion de instituciones, la elaboracion de incentivos y la movilizacion de intereses. Ninguna opcion por si sola es suficiente para afrontartodos los desafios asociados con la resistencia a los antimicrobianos. Las opciones institucionales prometedoras Incluyen hitos supervisados y un grupo de accion interinstitucional. Se podria utilizar un fondo combinado global para elaborar incentivos y nominar un representante especial como un movilizador de intereses. El problema de los antimicrobianos tiene tres componentes de las politicas: asegurar el acceso, la conservacion y la innovacion. Para abordar los tres componentes se necesita que la mezcla correcta de opciones se una a un foro efectivo, y podria necesitar el apoyo de un marco legal Internacional., Introduction Antimicrobial medicines now save millions of lives each year and many infectious diseases are far less deadly because of them. (1) However, bacteria, viruses, parasites and fungi develop resistance [...]

The recognition that many diseases present worldwide challenges has spurred nations and institutions to participate in the development of what is known as 'global health governance'. But this new form [...]

The author discusses the role of the U.S. Department of Health and Human Services (HHS) in global immunization. Topics include the success of the global health industry in addressing vaccine-preventable diseases (VPDs), the involvement of the National Vaccine Program and the National Vaccine Advisory Committee in global immunization efforts, and the development of the MenAfriVac vaccine for use outside cold chain conditions.

The pace of globalization has brought the world to the brink of a new era in international relations. While the world has outgrown traditional mechanisms for addressing global issues, it has not yet developed new forms of effective governance. This temporary void poses threats and enormous opportunities. The public health sector will play a crucial "formal" role--that is, carried out by existing bodies such as WHO and the UN. But WHO does not necessarily represent the full spectrum of views and its members necessarily work, to some degree, for separate national interests. The formal dimension must be supplemented. Globalization is not synonymous with lack of regulation. Many responsible businesses would welcome a transparent and universally applied regulatory regime to prevent a race to the lowest standards. The economic benefits of globalization may hit a glass ceiling if societies outside the global economy become progressively poorer and less healthy. The business community is recognizing that good health is essential for economic growth and social stability. Globalization may cause millions to migrate for economic opportunity. The private sector's forward-thinkers recognize the health threats of migration and are beginning to view global health promotion as a means to ensure optimal market access.