It may seem impossible to imagine a future where minor injuries and routine surgeries are life-threatening, or cancer treatment risky at all. But with antimicrobial resistance (AMR) on the rise, and unless there is urgent collective action, this may soon be our reality.
As we are still recovering from one pandemic, we need to prevent another; Which has the potential to be even more destructive.
AMR is a major health burden that killed nearly 1.3 million people in 2019[1] alone. The future outlook is even bleaker – AMR is predicted to kill 10 million people each year by 2050, a figure that currently surpasses the number of cancer deaths if no action is taken. , with economic losses estimated at up to $100 trillion.[2]
As we are still recovering from one pandemic, we need to prevent another; Which has the potential to be even more destructive. That’s why an EU Parliament event was organized earlier this month to address the growing threat of AMR ahead of World Antimicrobial Awareness Week. Hosted by Shionogi in partnership with the Active Citizenship Network and supported by the MEPs Interest Group on European Patients’ Rights and Cross-Border Healthcare, actionable solutions and policy changes to combat this significant global health threat are discussed.
A broken market for antimicrobials
AMR occurs when bacteria, viruses, fungi, and parasites multiply unless they respond to antimicrobials (medicines such as antibiotics). As a result, the infection becomes more difficult to treat and the risk of disease spread, severe illness, and death increases.[3]
New antibiotics are powerful weapons to help combat AMR. As pathogens continually evolve their responses to antimicrobials, new and innovative treatments are needed to outpace the development of resistance. However, the traditional economic model for drug discovery is failing when it comes to antibiotic development. Newer antibiotics should be used sparingly or as a last resort to maintain their effectiveness. For this reason, there is no viable market for new antibiotics: investment is lacking, and many pharmaceutical companies are abandoning antibiotic research and development (R&D) altogether, or indeed claiming bankruptcy. the resulting.
As pathogens continually evolve their responses to antimicrobials, new and innovative treatments are needed to outpace the development of resistance.
While several global and European initiatives – including the Global Action Plan by the World Health Organization (WHO)[3] and One Health Action Plan by the European Commission[4] To raise awareness and prioritize AMR, more practical and collaborative action is needed at the country level.
AMR: A second pandemic in the wake of COVID-19?
There are apprehensions that the COVID-19 pandemic has worsened the situation. This is due to a lack of early understanding of how to treat viruses, leading to widespread inappropriate use of antibiotics.[5]
Nevertheless, to some extent affected by the AMR epidemic,[6] And if we’ve learned anything from COVID-19, it’s that a global health threat that appears distant can suddenly emerge — devastating lives, health care systems, and economies in its wake.
Today, we are still facing the effects of the pandemic. And, as we reflect on the past three years, we realize how vulnerable our health care system really is to infections when we have limited or no standard treatments available to deal with them. This becomes an important concern with the emergence of multidrug-resistant infections.[7]
Urgent policy change advocated in EU Parliament
So, collectively, how can we address the threat of AMR and encourage the development of new antimicrobials?
An important starting point are new economic incentives, such as bridge incentives, that help encourage antibiotic R&D and support innovation. Pull incentives, such as new reimbursement models, partially or completely remove the revenue of new antibiotics from sales volume, thereby rewarding companies for providing effective antibiotics. This helps create a more predictable and sustainable market which encourages the development of new antimicrobials.
Mark Hill, senior vice president, global head of value and access at Shionogi, said: “We know it is important to encourage innovation in antimicrobial research and development and to build a pipeline of new and effective antibiotics, and this And necessary for both Europeans.” local country level. We have looked at specific examples of successful models that have been implemented in European countries, and urge other EU member states to follow suit and help address the challenges in bringing novel antibiotics to market. Consider similar incentives to help.
The meeting was important in raising awareness of antimicrobial resistance and the need for new innovations to address unmet needs.
The importance of these incentives was confirmed in the program of the EU Parliament. The event convened a high-level European policy meeting to discuss concrete examples of innovative frameworks being implemented by national health authorities to fight against AMR, taking into account the upcoming revision of EU pharmaceutical legislation and upcoming Council recommendations on AMR. brought the makers together.
“The meeting was critical to raising awareness of antimicrobial resistance and the need for new innovations to address unmet needs. I call on patient organizations, industry, the European Commission, academia and healthcare professionals to drive policy change and respond to this growing societal challenge. calling on us to work together to come up with a common response,” said MEP Aldo Petricello.
MEP Fabio Massimo Castaldo calls for encouraging private investment in new antibiotics, in addition to setting up rapid procurement and procurement mechanisms for crisis-relevant medical countermeasures to respond to emerging threats and better prepare European health systems It also reaffirmed the importance of developing a predictable regulatory environment for He added that “with the adoption of the Global Health Strategy and the Pharmaceutical Legislation Review, now is the time to act, and as members of the European Parliament, we will conduct a thorough review of these proposals to ensure they meet the necessary aims and ambitions.” Let’s fulfill”.
“We hope that the concrete recommendations from this event can be taken advantage of by the Member States,” said MEP Istvan Uzeli. “At the end of the day, we need to turn policies into practice, and for this to become a reality, Member States have an important role to play in acknowledging the challenge that AMR poses to society and health care systems and to act , implements plans and best practices. ,
Mariano Votta, director of the Active Citizenship Network, the European Union branch of the Italian NGO Cittadinandativa, said: “The inclusion of AMR within the work program of the incoming Swedish Presidency of the Council of the European Union and the prioritization of the subject by the European Health Emergency Preparedness and Response The Authority offers the opportunity to advance policy action to improve management, monitor resistance patterns across Europe and encourage innovation. These actions can be accomplished in one health strategies that provide solutions for human, animal and environmental health. The involvement of civil society and patient advocacy groups in the development and implementation of AMR national plans is also important.”
As a company that has been researching and developing drugs in infectious disease since 1878, Shionogi recognizes that implementing policy change requires time, stakeholder engagement and political goodwill, but if industry can coordinate our actions If we work together with governments and policy stakeholders to do so, we can make significant progress. at the regional and local country level. Shionogi is committed to ensuring that individual patients and society as a whole continue to benefit from effective antimicrobials, and we are calling on collaborative partners to join us in the fight against AMR.
[1] Antimicrobial resistance associates. The global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Lancet, 399:629–655 (2022).
[2] O’Neill J et al. (2016) Reviews on antimicrobial resistance. Tackling drug-resistant infections globally: final report and recommendations, https://amr-review.org/sites/default/files/160518_Final%20paper_with%20cover.pdf
[3] WHO (2016) Global Action Plan on Antimicrobial Resistance, https://www.who.int/publications/i/item/9789241509763
[4] European Commission (2017) A European One Health Action Plan against antimicrobial resistance (AMR), https://health.ec.europa.eu/system/files/2020-01/amr_2017_action-plan_0.pdf
[5] Cherry W et al. Rapid review of overuse of antibiotics during the COVID-19 pandemic: lessons learned and recommendations for the future. AMRC Open Research. 3:17 (2021).
[6] Cameron, et al. Antimicrobial resistance as a global health threat: lessons need to be learned from the COVID-19 pandemic. Available at: https://onlinelibrary.wiley.com/doi/10.1111/1758-5899.13049
[7] Adebisi YA et al. COVID-19 and antimicrobial resistance: a review. Infectious Diseases, 14 (2021).