Rethinking the fight against antimicrobial resistance

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Medicine Cabinet
Teodoro B. Padilla

(Second of two parts)

Each year, about 700,000 people die due to antimicrobial resistance (AMR). While the number is considered low compared with other diseases, deaths caused by AMR will reach 10 million every year by 2050 if no action is taken today. Health experts believe that AMR will claim more lives of people of all ages than cancer years from now.

The rise in antibiotic resistance has been dramatic, making it one of the major health challenges globally. AMR threatens to bring modern medicine back to the pre-antibiotic era where a simple infection could kill and life-saving surgeries would be impossible.

Ahead of the G20 leaders meeting in Germany early this month, health ministers from powerful economies raised concerns over this global health risk. Also called the Berlin Declaration of G20 Health Ministers, participants emphasized that both AMR and infectious disease outbreaks have a severe impact on the lives and well-being of millions of people as well as on the global economy. As an outcome, the Berlin Declaration called for a coordinated global response to prevent and cushion the adverse impact of health emergencies and AMR.

The World Health Assembly (WHA) recently endorsed a global action plan to address antimicrobial resistance. The global action plan sets out five strategic objectives focusing on: 1.) improving awareness and understanding of antimicrobial resistance; 2.) strengthening knowledge through surveillance and research; 3.) reducing the incidence of infection; 4.) optimizing the use of antimicrobial agents; and 5.) developing the economic case for sustainable investment that takes account of the needs of all countries, and increase investment in new medicines, diagnostic tools, vaccines, and other interventions.

Given the unique scientific, economic, public health, and environmental challenges presented by AMR, continued engagements and partnerships are important to ensure progress in this complex health threat.

The research pharmaceutical sector recognizes its critical role in slowing down AMR. Led by the International Federation of Pharmaceutical Manufacturers & Associations (IFPMA), it joined the Davos Declaration which called for collective action to create a sustainable and predictable market for antibiotics, vaccines, and diagnostics that enhances conservation for new and existing treatments.

As outlined in the Industry Roadmap for Progress for Combatting AMR, IFPMA members committed to four areas involving manufacturing and environment, information advocacy, medicine and vaccine access, and research and development.

The first area is the support for measures to reduce the environmental impact from production of antibiotics. This includes reviewing manufacturing and supply chains to assess good practices in controlling releases of antibiotics into the environment.

Second is the commitment to antibiotics only being used by patients who need them. Since it is an effort that should be shared by several stakeholders, the commitment is to support governments and public health workers to educate health care professionals and patients on the value and importance of using antibiotics appropriately. It also draws attention to uncontrolled over-the-counter antiobiotic purchases and non-prescription internet sales as well as counterfeit medicines.

Third is the support for mechanisms to facilitate affordable access to high quality antibiotics (both new and existing), diagnostics, and vaccines by the patients who need them, in all parts of the world and at all levels of income. This requires working closely to identify and address specific access, market sustainability, and supply issues and developing innovative financing and procurement mechanisms to resolve them. It also means the establishment of new business models which will improve access while supporting appropriate use and delivering an adequate return to companies.

Fourth is the support for new ways of working, such as open collaboration between industry and public researchers to overcome the scientific challenges of creating new antibiotics, vaccines, and diagnostics.

Finally, the Industry Roadmap reiterates its call for a comprehensive multi-sectoral approach to addressing the other factors contributing to, and impacted by, AMR. (For the full AMR Roadmap, visit www.ifpma.org).

Medicine Cabinet is a column of the Pharmaceutical and Healthcare Association of the Philippines (PHAP), representing the research-based medicines and vaccines sector in the country. The author is the executive director of PHAP. medicinecabinet@phap.org.ph.

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