Antimicrobial resistance: running out of time

Photo of the WHA Panel - The World Health Assembly panel on global antimicrobial resistance research on May 26, 2016.

GENEVA – With forecasts of 10 million deaths per year—more than current annual cancer deaths—and $1 trillion in lost economic output from antimicrobial resistance by 2050, AMR surged to the top rank of health concerns at this week’s World Health Assembly.

“We are running out of treatments, and we are running out of time,” Angelique Berg, Director-General of the Netherlands, told a packed side event on global AMR research and innovation on Thursday. “These concerns are very real. No major class of antibiotics has been discovered since 1987. And too few antibiotics are in development. I believe global cooperation and financing is necessary.”

Experts on the panel emphasized new financing methods for research because pharmaceutical companies have largely abandoned antimicrobial development because it’s seen as a money loser. After a new antimicrobial reaches the market, physicians typically prescribe them sparingly in order to conserve its effectiveness—causing companies to see return on investment take decades.

A Big Pharma CEO will probably prefer a profitable oncology drug over a new antibiotic drug that will likely lose $50 million, said Joe Larsen, an acting deputy director from the Biomedical Advanced Research and Development Authority (BARDA) in the US Department of Health and Human Services. “We need to look at ways to change that calculus,” Larsen said.

One promising plan announced this week at WHA is the Global Antibiotic Research and Development partnership between WHO and Drugs for Neglected Diseases initiative. GARD will work in cooperation with the public and private sectors to develop new antibiotic treatments. GARD aims to have two projects ready for implementation by the end of the year and two more by the end of 2017, according to a statement.

“The guiding principle is that R&D should focus on significant bacterial infections with emphasis on global needs,” said Bernard Pécoul, DNDi executive director. “We have concerns of conservation [preserving new drugs’ effectiveness] but we also have a big concerns of access.”

GARD has secured more the 2 million Euros in seed funding for its launch from Germany, the Netherlands, South Africa, the UK and MSF.

Hala Audi, a team leader of the influential Review on Antimicrobial Resistance, proposed other funding mechanisms including a global innovation fund focused on antimicrobial development sthat would support basic, not for profit research required to fill in the current blind spots. The proposal would reward a companies that bring to market new antibiotics with $1–1.5 billion while also ensuring that product cost would not prohibit patient access to the drugs. Her team envisions that $25 billion in funding could ultimately produce 15 new antibiotics.

Later, event moderator Dame Sally Davies, England’s chief medical officer, said she was encouraged by international recognition of AMR’s threats to human health. “Clearly all of the countries are on board. We need to do something,” Davies said. “Everyone has signed on to the global action plan and now they’re putting their national action plans in place; but what this side event has shown is we need to be collaborative and creative about new R&D models as well as increase the amount of funding.”

AMR will be a major topic at September’s UN General Assembly meeting in New York. “The objective for the General Assembly is to raise awareness to heads of state and to start to show people the economic impact of not taking action,” Davies said. “The fact that we could lose the battles on TB, malaria as well as increased lives lost from nasty bacteria—I hope we’ll be ambitious but that is really up to the world as a whole.”

Brian W. Simpson, Global Health NOW editor-in-chief, reported from Geneva on the World Health Assembly from May 23 to 28, 2016. Visit this page for more GHN stories from the 69th World Health Assembly.

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