York U study warns gaps in antibiotic access pose global health threat

Originally published by YFile (11 February 2026)

By Ashley Goodfellow Craig

Migrants and refugees face an increased risk of unsafe antibiotic use and resistance which poses a significant global health threat, according to new research led by York University.

Researchers at York’s Global Strategy Lab undertook a study to understand the difficulties these groups face and found barriers at every stage of the health care pathway.

Significant structural, financial and systemic challenges lead to informal or incorrect use of antibiotics, the research finds, which increases the risk of antibiotic resistance and misuse.

Resistance occurs when antibiotics are used too often or incorrectly, making them less effective and leaving infections more difficult to treat. Globalization, which drives people to migrate due to rising economic, political and environmental instabilities, has increased migrants’ and refugees’ vulnerability to drug-resistant infections.

“Migrants and refugees are at heightened risk because they often live in crowded or unstable conditions, have limited access to health care and sometimes rely on unsafe sources of antibiotics – all of which make antibiotic resistance more likely,” explains Steven Hoffman, Faculty of Health and Osgoode Hall Law School professor and co-author of the study.

Published in Globalization and Health, the study synthesizes global evidence from both patients and heath care systems to identify disruptions along the continuum of care and offer solutions.

It identifies language barriers, unfamiliar health care systems, stigma, financial challenges, long wait times and fear of discrimination or deportation as some of the key challenges facing these groups.

“When people can’t easily see a doctor or afford prescribed medication, they may turn to informal options – such as buying without a prescription – to acquire and use them which can result in incorrect or unnecessary antibiotic use,” says Suzanne Garkay Naro, policy advisor II at the Global Strategy Lab and lead author of the study.

Additionally, gaps in health care services – such as translation support and diagnostic accuracy – are frequently cited as obstacles to safe antibiotic access.

Researchers say governments can reduce barriers by expanding language services, improving cultural competency in health care and removing the financial and legal challenges that prevent people from visiting a doctor or filling a prescription.

They also urge stronger global coordination, such as tracking antibiotic resistance in migrant and refugee populations and ensuring quality-assured antibiotics are available in low-resource settings.

"Fair access, clear communication and stronger international policies are critical to ensuring antibiotics are used safely and appropriately,” says Naro.

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