Enhancing access to antimicrobial resistance diagnostics for the marginalized: Challenges and opportunities of point-of-care technologies.

Abstract

Inadequate access to antimicrobial resistance (AMR) diagnostics remains a critical challenge, particularly in low- and middle-income countries (LMICs). Despite various global policy commitments, translating these policies into practice is restricted by socio-economic barriers, technological limitations, and infrastructure gaps. Based on ongoing empirical work in India under EquityAMR, diagnostic inequities were examined in two contrasting states. The spatial analysis demonstrated disproportionate diagnostic services, due to urban-rural and hilly-plains regions. Further laboratory assessments across 14 health institutions in these two states highlighted critical gaps in testing capacity, quality control, equipment, and data management. In addition, the potential of existing point-of-care technologies in expanding access were examined based on WHO criteria of clinical preparedness, scalability, and sustainability, although none were considered suitable for all three criteria. The study concluded that by arguing in the current scenario, traditional culture-based microbiology facilities can be established in sub-district facilities with some success in expanding access.