Pay now or pay later: Strategies for combating antimicrobial resistance

Research!America

A global solution and removing barriers to antibiotic development are necessary to combat antimicrobial resistance (AMR). Representatives from various research and health sectors discussed strategies for fighting superbugs at a BIO International Convention super session today. The panel agreed there must be a greater focus on streamlining clinical trials and harmonizing the global regulatory process to support the development of new antibiotics.

Jim O'Neill, chairman, Review on Antimicrobial Resistance, recommended the establishment of a global $2 billion AMR Innovation Fund over five years funded by industry to help jump start product development. Venture capitalist risk could stimulate the pipeline and help get more drugs to market. "The global cost if we don't do anything about it" is massive compared to the cost of taking action now, he said. O'Neill said he will recommend adding antimicrobial resistance to the G20 agenda next year in China.

Julie Gerberding, executive vice president for strategic communications, global public policy and population health of Merck said we need investments in innovation to finding new antibiotics. However, industry is working in a different regulatory environment and companies are under more intense scrutiny. "We can't place the same bets we placed ten years ago," she said.  "We need predictability and reliability going forward to make the investments worthwhile." A stronger World Health Organization (WHO) could take the lead in fighting AMR, she noted, but current funding and governance are not optimized as such to enable WHO to provide such leadership.

Patients with antimicrobial resistance have limited medical options in treating other health conditions due to their infection. "The fear is becoming reality to some extent and it's no better time than now to act," said Helen Boucher, director, Infectious Diseases Fellowship program, Tufts Medical Center. She added that surveillance is key to track patients with AMR who travel globally. 

The science of antibiotics is incredibly hard and requires significant investments, noted Kenneth Hillan, CEO, Achaogen. But he doesn't believe that industry will take the lead. Antibiotics "economically don't make sense for pharmaceutical companies." He said the great success of drug development for orphan diseases could be an economic model for solving antimicrobial resistance. In the last five years, the Food & Drug Administration (FDA) approved 55 new molecular entities for orphan diseases, and companies focusing on these diseases are thriving.

"We can't wait until we have a global epidemic of so-called superbugs" to convince stakeholders to make the investments, said Steve Solomon, principal, Global Public Health Consulting. He claimed there's a surprising lack of advocacy on the ground level and national level on this issue. People need to coalesce around this health threat and promote what needs to be done, he added.

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