In 2014, the World Health Organization announced that antimicrobial resistance (AMR) – and more specifically antibiotic resistance – was no longer a prediction but an actual reality that is putting at risk the ability to treat common infections.
It warned, furthermore, that without urgent, coordinated action, the world was hurtling towards a post-antibiotic era, in which common infections and minor injuries could once again kill. The European Commission is more direct: “If the current trend is not altered, 300 million people worldwide are expected to die prematurely because of drug resistance over the next 35 years.”
In short, it is now time for the pharmaceutical industry and other stakeholders to rise to the challenge with commitment and speed.
With the “Declaration by the Pharmaceutical, Biotechnology and Diagnostics Industries on Combating Antimicrobial Resistance”, we have done just that and more to address the significant innovation gap. Our industries stand ready to work in partnership with leading countries to deliver sustainable solutions to meet this global challenge.
So what precisely are we offering through this Declaration? The obvious aim is to stem the progression of antimicrobial resistance. Accordingly, the signatories commit to ensuring that antibiotics are only used in those patients who actually need them. This comes with a pledge to support education for clinical professionals on appropriate use – and we welcome the WHO Global Action Plan’s focus on improved stewardship.
We must also look at improving overall hygiene, vaccination, and preventive treatments – it’s a step in the right direction to slashing the number of infections that need antibiotic treatment.
As signatories to the Declaration, we are throwing our weight behind measures to cut environmental pollution from antibiotics. This is accompanied by a “one health” approach, promoting a prudent and responsible use of antibiotics and a concerted drive to reduce unnecessary antibiotic use in livestock.
On the R&D and financing front, we recognise the need for more work and investment in multiple approaches to overcome the significant scientific difficulties of antibiotic discovery. Research carried out in academia and SMEs on new and re-purposed antibiotics remains vital, but we’re also looking at new ways of working, including open collaborations between industry and public researchers. The New Drugs for Bad Bugs (ND4BB) programme – part of the Innovative Medicines Initiative – is testimony to what effective private partnership in this field can achieve.
There is another major hurdle, though: the value given to antibiotics and diagnostics rarely reflects the investment required to develop them. We’re therefore pushing for investment via coordinated global routes, targeting the development of diagnostics, antibiotics, vaccines, and alternative technologies.
The signatories are also ready to work with payers and policymakers to devise new valuation mechanisms and commercial models.
Our commitment is ongoing: we will review and update the Declaration every two years, to reflect progress and changing priorities.
We can’t do this alone, though, and we have to learn from one another. The industry is committed to working with governments, researchers and civil society in order to turn ideas to tackle the problem of AMR into action.
It is important to stress that improving financial and access-related predictability for both Industry and health systems is also key to ensuring sustainable investment in new antibiotics and diagnostics.
Nevertheless, the bottom line: we will improve affordable access to high-quality antibiotics and ensure the availability of new ones to all patients who need them, no matter where they are and no matter what their income.
If we have succeeded in increasing global access to drugs in HIV, TB, and malaria, there is no reason that – through collaborative effort – we cannot and will not be able to do the same for antibiotics.3