On the occasion of European Antibiotic Awareness Day, 18 November, EFPIA’s Brendan Barnes writes on what it will take to successfully implement the WHO’s global action plan on anti-microbial resistance.
Last week the Norwegian Government organized a stakeholder consultation meeting to discuss implementation of the World Health Organization’s Global Action Plan on antimicrobial resistance. The hosts were very conscious that the World has seen a number of false starts in addressing AMR and with each failure our ability to counter emerging threats has diminished. Perhaps this time is different.
Beginning with the Swedish EU Presidency in 2009, there has been a sustained engagement by successive presidencies and committed Member States, such as the UK and the Netherlands. In this context the WHO’s plan is pretty crucial, not because it will bring new money (it won’t, at least not overnight) but because it will communicate what each stakeholder should commit to overcoming the threat of AMR. The challenge is so great that we need the engagement of all stakeholders, but at the same time we need pragmatism if we are not to create disillusionment and resistance. The Oslo meeting highlighted this question in its discussion of the impact of economic incentives on the development, marketing , distribution and dispensing of antibiotics.
In summary, we have a system that in many places, in many ways, is fuelled by the sales of antibiotics. That cannot be right, and there was an understandable emphasis on restriction and prohibition in Oslo. However, we are going to need more than just tighter regulation, particularly as regulatory systems are weak in many countries. In a situation where we have deficient pipelines of new antibiotics and severe barriers in making those we do have available to those who need them, we need to ensure that those who are prepared to act responsibly still have a reason to engage.
The pharmaceutical industry has already put its cards on the table. We need a new business model which is not dependent on volume sales. We need to re-evaluate the role of promotion and see if it can be made an aid to antibiotic conservation. If that cannot be achieved, we need to ensure that it does not promote over-consumption. Also, and this is not just an issue for the industry, we need a joined-up approach to agreeing where the research needs are.
Not only have we taken these positions, but we have, together with the European Commission, committed a major part of the resources of the Innovative Medicines Initiative to building a new more collaborative R&D model. One recently-launched component of the IMI AMR programme is called DRIVE-AB and is focused on designing the new business model, encompassing the above points. DRIVE-AB will draw on many sources of expertise and could be a key resource for WHO in thinking through this aspect of AMR. For that to happen it is important that the Action Plan acknowledges the work that is being done through IMI and elsewhere, enabling WHO to build on the commitment that exists to regain the upper hand over infectious disease and perhaps, make the breakthrough that has eluded us in the past.
Find Out More
WHO draft global action plan on antimicrobial resistance – http://www.who.int/drugresistance/amr_global_action_plan/en/
The Innovative Medicines Initiative programme, DRIVE-AB (Driving reinvestment in R&D for antibiotics and advocating their responsible use) – http://drive-ab.eu/
European Antibiotic Awareness Day is marked annually on 18 November. The 2014 European Antibiotics Awareness Day focuses on self-medication with antibiotics. – http://ecdc.europa.eu/en/EAAD/Pages/Home.aspx0