Collaborative partnerships as a solution for poor access to essential antimicrobial medicines: what can we learn from the chlorhexidine gel example?

Low-income and middle-income countries (LMICs) have the highest infectious disease burden, antimicrobial resistance levels and associated deaths, but access to antimicrobials is limited, and the prevalence of substandard and falsified antibiotics is high. This causes the use of no, ineffective or unnecessary broad-spectrum antimicrobials, leading to poor outcomes, under-5 mortality and resistance.1 Access to preventative antimicrobials, for example, antiseptics, is essential, but supported by few international efforts.1 Daily umbilical antisepsis with chlorhexidine digluconate can save 7/1000 newborns in contexts with harmful umbilical cord care practices. Here, we discuss opportunities and challenges of access initiatives, based on the experience of a public–private partnership to improve access to chlorhexidine for umbilical cord care.