While the whole world has been taken aback by the COVID-19 pandemic, another severe, and silently growing, threat is slowly entering the spotlight: Antimicrobial Resistance (AMR). More than 33,000 people in Europe die annually as a result of AMR, and it is estimated that resistance to antimicrobials costs the EU around €1.5bn a year in healthcare costs and productivity losses.
According to a recent UN Report, by 2050, AMR could potentially lead to the death of ten million people annually. World leaders have been talking about acting in this field for many years, yet so far very little has been done and no one has actually walked the talk.
AMR affects us all, and countries around the world will face dramatic social and economic consequences if we do not manage to stop its spread. Superbugs resistant to antibiotics not only endanger lives, they threaten to undermine every aspect of modern medicine.
“AMR affects us all, and countries around the world will face dramatic social and economic consequences if we do not manage to stop its spread”
This is why we need to act now to safeguard the scientific achievements of the last century. Like COVID-19, AMR represents a serious cross-border health threat. It is also on the WHO’s list of ten threats to global health. In comparison to COVID-19, we know that AMR is here to stay, and we know that we need to act now. Yet too many people are still unaware of this issue.
The awareness of the relationship between the use of antimicrobials and the development and spread of AMR is still low. Among other things, we need to stop the misuse and overuse of antibiotics, offer alternative treatments and provide stewardships for healthcare professionals.
Furthermore, monitoring and surveillance need to be strengthened, as do infection prevention and control. There should also be a focus on better access to rapid and affordable diagnostic tools. AMR is an example of modern market failure that raises a unique industrial dilemma.
On the one hand, we need industry to invest in research and development in order to identify novel antimicrobials, which is a very cost-intensive process. On the other hand, we need these novel antimicrobials to be used as little as possible in order to have them as a reserve; meaning there is likely to be few profits for developers.
The balance between costs and profits is the biggest barrier in developing new drugs. This is also the reason we see many companies enter bankruptcy at the later stages of development. This is the reason why the EU, and specifically the European Commission, has to finally put legislation on the table to address AMR.
We need better push and, explicitly, new pull incentives in order to secure funding for companies that develop new antibiotics. I am well aware that we need to reinforce the One Health approach across the EU, connecting human health, animal health and environmental protection, but I want to focus on incentives for the industry, particularly when it comes to developing novel antibiotics.
The EU already has measures - such as the Innovative Medicines Initiative on Antimicrobial Resistance (AMR) Accelerator - in place.
That aims to drive the development of new medicines to treat resistant bacterial infections in Europe and beyond. There is no single approach that fits all. We need to support the development of needs-driven models to fix the antibiotic development pipeline.
At the same time, we need to ensure both the prudent use of new drugs, as well as equitable and affordable access; quite the challenge. We are severely lacking the pull incentives to actually bring new antibiotics to the market.
Therefore, the Commission should look into decoupling the price and volume of antibiotic sales from research and development costs through alternative mechanisms.
One example the EU could consider is the ‘subscription-style’ payment model for novel antimicrobials, started in the United Kingdom. Separating payment from the use of antibiotics could make them commercially attractive again.
“We, the MEP Interest group on AMR, are pushing the Commission to come up with a binding legislative proposal on combatting AMR. The times of action plans and guidelines are over. We need to act now, not in the years to come”
Moreover, the Commission should take an end-to-end approach, targeting public investment across the entire chain, from global priority setting, to early discovery, through the product development phase, to appropriate and affordable patient access.
We, the MEP Interest group on AMR, are pushing the Commission to come up with a binding legislative proposal on combatting AMR. The times of action plans and guidelines are over. We need to act now, not in the years to come.
The industry has already taken the first step by providing much-needed funding with the AMR Action Fund. However, this is only a drop in the ocean. Governments and industry must work together to produce new antibiotics and ensure that we can continue to treat common diseases. People’s lives depend on us having effective antibiotics. We have no time to lose. It is as simple as that.