Europe is searching for solutions. The Commission has issued a white paper setting out alternatives visions of the future of the European Union – and, of course, there’s Brexit. In parallel with its search for internal direction, the EU is being challenged in relation to its external role. How real is “soft power” in the European neighbourhood of today?
In looking for how to contribute to domestic and global issues, the EU does not need to look further than the issue of anti-microbial resistance (AMR). This is an issue that plays to uniquely European capacities for dialogue and cooperation and, what is more, we are in the lead, with excellent examples of best practice and EU Member states holding both G7 and G20 presidencies in 2017, while providing some of the most innovative thinking.
AMR is a global problem – how do we maintain the capacity to treat infection while it is being eroded constantly by resistance? It is also a personal problem. Many – if not most – people will know someone whose hospital treatment has been affected by the need to treat a problematic infection. At the level of health systems, the ability to treat infections underpins the provision of other forms of care.
There are relatively few quick wins in this area, but there are some high risk areas to be addressed. One of these is the need to reinvigorate innovation into counter-measures, be these antibiotics, vaccines or other approaches. The reason for proposing this prioritisation is that the lead times needed to reverse the current shortfall in innovation are lengthy and, although we can do a great deal to counter resistance through other measures, in the end we need the safety offered by effective treatment and prevention.
A lot is happening. We are at the stage when political engagement needs to turn into concrete action. The G7 prioritised this issue in 2016, and will revisit it at its 2017 meeting under Italian leadership. The G20, led by Germany, will also address the issue and will receive a report from the OECD on the possible solutions to the innovation problem. Specific ideas are also emerging. The Germans have sponsored a report laying out the shape of a new innovation system; a commission-industry joint project called DRIVE AB – housed under the umbrella of the Innovative Medicines Initiative – will report later this year; and the UK is engaged in detailed discussions, as are other Member States. At a global level, a global action plan has been developed by WHO.
For its part, the industry has recognised that it must offer a broad-based response to this problem and has laid out a series of commitments, first in a Declaration, issued in January 2016, and endorsed by over 100 organisations. This was followed later in the year by a more detailed Roadmap, signed by some of the key companies active in the area. Plans are now underway to track and update progress on these commitments.
What is the EU doing? The EU approach is framed around the One Health concept, which proposes that we need to tackle all the aspects of this problem in an holistic approach. It’s an approach where the management of veterinary practice is a factor, as is the screening of patients in hospitals. One Health makes sense, although it is intimidating in its breadth. There is no single solution to AMR. One Health will also, no doubt, underpin the new EU AMR Action Plan, which is expected in mid-year 2017. In addition, the Commission is expected to produce guidelines on the prudent use of antibiotics in humans, paralleling already-existing guidelines for the veterinary sector.
Looking to the innovation deficit, there is clearly an opportunity to build on political developments this year and last, and there is little doubt that the EU is well-placed to take the lead. We have extensive experience of the type of intersectoral and public-private collaboration that will be essential to progress. A lot of the thinking is taking place in Europe and, finally, the EU has the critical mass to make a difference globally both in stimulating innovation and in providing comprehensive policy approaches for managing the precious resources that keep us safe from untreatable infection.
EFPIA and its members stand ready to find and implement novel solutions. It is essential that the EU action plan is supportive of that engagement. This could take the form of sponsoring structured discussions on the thinking about new innovation models emerging at Member State and multilateral level, but also of ensuring that all stakeholders are involved in delivering on One Health.1