Time is fast running out for us to develop vital new antibiotics to avert, what Lord Jim O’Neill, Chair of the UK’s Antimicrobial Resistance team, defined as an international crisis. In fact, Lord O’Neill has suggested that by 2050, a drug-resistant infection will kill someone every three seconds, “unless we act now”. Former UK Prime Minister David Cameron put it even more bluntly, suggesting that, without action, we would be looking at “an almost unthinkable scenario, where antibiotics no longer work and we are cast back into the dark ages of medicine”.
So it is time to reassure people that the European Union and the pharmaceutical industry are by no means resting on their laurels. In fact, the EU has thrown its weight behind efforts to combat the rise of AMR since 1999, cementing this commitment at the heart of its strategically-important Horizon 2020 research programme and ploughing some €1 billion into AMR research.
As early as 2011, the European Commission had already put in place a 12-point Action plan against the rising threats from AMR, calling for a holistic approach. This is in line with the One Health Initiative, a movement that seeks to forge co-equal, all inclusive collaborations between physicians, osteopathic physicians, veterinarians, dentists, nurses and other scientific-health and environmentally related disciplines.
The EU has furthermore been the prime mover in the Joint Programming Initiative on AMR (JPIAMR). With the voluntary agreement of Member States, within the framework of a partnership approach, the initiative aims to pool national research efforts in order to make better use of Europe’s public R&D resources and to tackle AMR more effectively, rather than relying on national – often fragmented – research programmes. JPIAMR’s membership now consists of 22 countries, including seven from outside the EU.
The pharmaceutical industry has also been keen to seize the gauntlet thrust down by AMR, joining with the EU within the framework of the Innovative Medicines Initiative (IMI and IMI2) – the world’s largest public-private partnership in the life sciences sector. Together we have created the New Drugs for Bad Bugs (ND4BB) programme, which has seen the number of contributing large pharma companies leap from four to eleven over five years.
In fact, ND4BB represents an unprecedented partnership between industry, academia and biotech organisations to fight AMR in Europe by tackling the scientific, regulatory, and business challenges that are hampering the development of new antibiotics. It enjoys funding of some €650 million across seven projects, that include: getting drugs into bugs (and keeping them there); creating a drug-discovery platform for antibiotics; taking on the most dangerous resistant bacteria; and establishing a pan-European network of clinical sites.
Europe is also home to the rapidly-expanding BEAM Alliance, a collaboration of European small and medium biopharmaceutical companies involved in developing innovative products to tackle antimicrobial resistance. The Alliance is committed to working to improve the regulatory, investment, and commercial environments in Europe for research, development, approval and market viability of new products combating antimicrobial resistance.
So we have built a vast array of weaponry designed to tackle the threat of AMR head on, but none of this is of any value unless we simultaneously address the mistakes of the past, including over-prescribing. What Europe has been crying out for is clear guidance to help us ensure that antibiotics are used appropriately to safeguard their effectiveness for future generations. This is a goal that is unachievable without the development of better diagnostics.
It cannot be stressed enough that our ability as Europe and even as a world to combat the emergence of AMR can only be realised through effective collaboration and a dogged commitment to maintaining the momentum of this effort. Without these two elements, what is now a challenge could transform rapidly into an existential threat.0