Urgent policy change is needed to tackle antimicrobial resistance

Urgent policy change is needed to tackle antimicrobial resistance

It may seem impossible to imagine a future where a minor injury and routine surgery are life-threatening, or cancer treatments are too risky to implement. But with antimicrobial resistance (AMR) on the rise, and unless there is urgent collective action, this may soon be our reality.

While we are still recovering from one pandemic, we must prevent a second; one that has the potential to be even more catastrophic.

AMR is a major health burden that claimed the lives of nearly 1.3 million people in 2019[1] only. The outlook for the future is even bleaker – AMR is expected to kill 10 million people each year by 2050, a figure that exceeds the number of deaths currently caused by cancer, with projected economic losses of up to $100 trillion. dollars, if no action is taken.[2]

While we are still recovering from one pandemic, we must prevent a second; one that has the potential to be even more catastrophic. That’s why a European Parliament event took place earlier this month to address the growing threat of antimicrobial resistance ahead of World Antimicrobial Awareness Week. Organized by Shionogi, in partnership with Active Citizenship Network and endorsed by the MEPs Interest Group on European Patients’ Rights and Cross-Border Healthcare, the event discussed concrete solutions and policy changes needed to counter this critical global health threat.

A broken market for antimicrobials

AMR occurs when bacteria, viruses, fungi, and parasites evolve until they no longer respond to antimicrobials (drugs such as antibiotics). As a result, infections become more difficult to treat and the risk of disease spread, serious illness and death is increased.[3]

New antibiotics are powerful weapons to help fight AMR. As pathogens continually evolve in their response to antimicrobials, new innovative treatments are needed to accelerate the development of resistance. However, the traditional economic model of drug discovery fails when it comes to antibiotic development. New antibiotics should be used sparingly or as a last resort to preserve their effectiveness. For this reason, there is no viable market for new antibiotics: investment is lacking and many pharmaceutical companies are abandoning antibiotic research and development (R&D) altogether, or even declaring bankruptcy as a result.

As pathogens continually evolve in their response to antimicrobials, new innovative treatments are needed to accelerate the development of resistance.

While several global and European initiatives, including the World Health Organization (WHO) Global Action Plan[3] and the European Commission’s One Health Action Plan[4] — have raised awareness and prioritized antimicrobial resistance, more pragmatic and collaborative action is needed at country level.

RAM: a second pandemic after COVID-19?

There are fears that the COVID-19 pandemic has exacerbated the situation. This is due to an initial lack of understanding of how to treat the virus, leading to widespread inappropriate use of antibiotics.[5]

Nevertheless, RAM has been somewhat overshadowed by the pandemic,[6] and if we’ve learned anything from COVID-19, it’s that a global health threat that seems distant can suddenly manifest itself – devastating lives, health systems and economies in its wake.

Today, we are still dealing with the ramifications of the pandemic. And, as we reflect on the past three years, we realize how vulnerable our healthcare systems really are to infections when we have little or no standard treatments available to fight them. This is becoming a significant concern with the emergence of multidrug resistant infections.[7]

Advocacy for urgent political change in the European Parliament

So, collectively, how can we address the threat of AMR and encourage the development of new antimicrobials?

An important starting point is new economic incentives, such as pull incentives, which help encourage antibiotic R&D and support innovation. Demand-side incentives, such as new reimbursement models, partially or fully decouple new antibiotic revenue from sales volume, rewarding companies for making effective antibiotics available. This helps create a more predictable and sustainable market that encourages the development of new antimicrobials.

Mark Hill, Senior Vice President, Global Head of Value and Access, Shionogi, said, “We know driving innovation is critical to driving antimicrobial R&D and a pipeline of new and effective antibiotics, and this is needed both at European and local country level. We have seen specific examples of successful models that have been implemented in European countries, and urge other EU Member States to follow this example and consider similar incentives to help address the challenges faced during the marketing of new antibiotics.

The meeting was crucial in raising awareness about antimicrobial resistance and the need for new innovations to address unmet needs.

The importance of these incentives was affirmed at the European Parliament event. In view of the upcoming review of EU pharmaceutical legislation and upcoming Council recommendations on AMR, the event brought together high-level European policy makers to discuss concrete examples of innovative frameworks led by health authorities national efforts to combat AMR.

“The meeting was crucial in raising awareness about antimicrobial resistance and the need for new innovations to address unmet needs. I call on patient organisations, industry, the European Commission, academia and healthcare professionals to work together to drive policy change and put in place a common response to this growing societal challenge,” the MP said. European Aldo Patriciello.

by Shionogi

MEP Fabio Massimo Castaldo also affirmed the importance of developing a predictable regulatory environment to incentivize private investment in new antibiotics, in addition to establishing rapid supply and purchase mechanisms for medical countermeasures. relevant in the event of a crisis in order to respond to emerging threats and to better prepare European health systems. He said that “with the adoption of the Global Health Strategy and the review of the pharmaceutical legislation, the time has come to act, and as members of the European Parliament we will examine these proposals in depth to ensure that they meet the necessary objective and ambition”. .

“We hope that the concrete recommendations of this event can be used by member states,” added MEP István Ujhelyi. “Ultimately, we need to put policy into practice, and for this to become reality, Member States have a vital role to play in recognizing the challenge that antimicrobial resistance poses to society and healthcare systems. health and the implementation of actions, plans and best practices.”

Mariano Votta, Director of Active Citizenship Network, the European branch of the Italian non-governmental organization Cittadinanzattiva, said: “The inclusion of AMR in the work program of the upcoming Swedish Presidency of the Council of the EU and prioritization of the subject by the European Council Health Emergencies Preparedness and Response Authority provides an opportunity to advance policy action to improve the management, monitoring of resistance patterns across Europe and encourage the innovation. These actions should be fully integrated into One Health strategies offering solutions for human, animal and environmental health. The involvement of civil society and patient advocacy groups is also crucial in the development and implementation of national plans on antimicrobial resistance. »

As a company that has been researching and developing drugs for infectious diseases since 1878, Shionogi recognizes that implementing policy change takes time, stakeholder engagement and political goodwill, but we can make meaningful progress if industry works closely with governments and political stakeholders to coordinate our actions. at the regional and local level of the country. Shionogi is committed to ensuring that individual patients and society as a whole will continue to benefit from effective antimicrobials, and we call on collaborative partners to join us in the fight against antimicrobial resistance.

[1] Collaborators on Antimicrobial Resistance. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Lancet, 399: 629–655 (2022).

[2] O’Neill J et al. (2016) Antimicrobial Resistance Review. Combating Drug-Resistant Infections Worldwide: Final Report and Recommendations, https://amr-review.org/sites/default/files/160518_Final%20paper_with%20cover.pdf

[3] WHO (2016) Global Action Plan on Antimicrobial Resistance, https://www.who.int/publications/i/item/9789241509763

[4] European Commission (2017) A European One Health Action Plan against Antimicrobial Resistance (AMR), https://health.ec.europa.eu/system/files/2020-01/amr_2017_action-plan_0.pdf

[5] Cherry W et al. A rapid review of antibiotic overuse during the COVID-19 pandemic: lessons learned and recommendations for the future. CDMA Open Research. 3:17 (2021).

[6] Cameron, et al. Antimicrobial resistance as a threat to global health: the need to learn lessons from the COVID-19 pandemic. Available at: https://onlinelibrary.wiley.com/doi/10.1111/1758-5899.13049

[7] Adebisi YA et al. COVID-19 and antimicrobial resistance: a review. Infectious Diseases, 14 (2021).

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