Last week, the Review on Antimicrobial Resistance, published its final report on Tackling Drug-Resistant Infections Globally. The document represents an important call for action in the global fight against AMR and is expected to have a huge impact on the current debate. Setting the scene, the report states that 700,000 people die of drug-resistant infections every year and estimates that the number of deaths from these could escalate to 10 million each year by 2050, unless action is taken now. Fittingly, the first recommendation calls for a large-scale global public awareness campaign to improve public understanding of the problems of drug resistance.
The report highlights the problem as twofold: on one hand the supply of new medicines is insufficient to keep up with the increase in drug resistance; on the other, huge quantities of antimicrobials, in particular antibiotics, are wasted globally on patients and animals who do not need them, while others who need them do not have access. Consequently, the report presents recommendation both for reducing the unnecessary use of antimicrobials, both for better incentives to promote investment for new drugs and improving existing ones. These include the establishment of a ‘Market entry rewards’ system in order to provide lump-sum payments to successful developers of new critical antibiotics; and the setting up of national and regional ‘clinical trial networks’ for antibiotics in order to reduce the cost and duration of antibiotic development. Moreover, the Review calls on governments, public and philanthropic research funding organizations to collaborate in the establishment of a Global Innovation Fund for early-stage and non-commercial research into new antimicrobials.
The question now is the following: how can the fight against AMR be funded? A number of options are presenting from using (and re-orienting) existing funding streams to the creation of entirely new funding streams. One way this may be implemented is through a ‘pay or play’ funding scheme – under which companies will be given the possibility to decide whether to pay a charge or demonstrate that they are investing at least the equivalent amount into R&D – or a tax on sales of existing antibiotics.
While the report includes many valuable insights and recommendations, it will take much more debate before decisions on how to combat AMR are taken at a global level. Let’s just hope it doesn’t take too long.
There continues to be a lot of focus of course – this week AMR is high on people’s minds at the World Health Assembly and will also be discussed in the context of the G7 meeting. Speaking before the kick-off of the World Health Assembly in Geneva, Keiji Fukuda, WHO assistant director-general, cited the UK report and said that the G20 meeting chaired by China (4,5 September) could lead to an agreement about how to get new drugs or how to pay for them, while the UN General Assembly (20-26 September) could lead to a high-level agreement on other aspects of AMR. 2016 seems the most important year for the fight against AMR: if not now, when?
Nicola Scocchi is Consultant in FTI Consulting’s healthcare team in Brussels.