Pharmaceutical systems resilience and access to essential medicines in conflict-affected regions: The case of antibiotics in Northern Syria

Ensuring equitable access to medicines is a core function of pharmaceutical systems, that are specifically mandated to ensure medicines’ availability, affordability, quality, and rational use. Conflicts and disasters cause the disruption of pharmaceutical systems and hamper their performance. Within Northern Syria, an area heavily affected by a long-term conflict and by recent major earthquakes, I will apply an interdisciplinary research approach to advance the evidence about how conflicts and disasters affect pharmaceutical systems and their resilience mechanisms to shocks; and to measure the key-outcomes of the local pharmaceutical system, by pinpointing essential antibiotics as tracers. Antibiotics were chosen due to their key role in the treatment and control of infectious diseases, especially relevant in the midst of conflicts and disasters, and their connection to the emergence of antimicrobial resistance. In addition, my research aims to contribute to the body of knowledge on health systems strengthening in fragile settings, by adapting the standard research methodologies for studying access to medicines in conflict settings, so as to empower our and other research groups to collect high-quality data (resulting in evidence-informed policies) despite the contextual constraints that limit the applicability of standard research methods. To prepare and conduct the study, I have planned visits to three related research institutions in The Netherlands, The UK, and Belgium.