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Antimicrobial resistance: We need to act now

Andrea Chiarello

Head of EU Government Affairs, Pfizer
Chair, Healthcare Committee, AmCham EU
22 Sep 2021
Healthcare

Tuberculosis. Gonorrhea. Pneumonia. These bacterial infections, formerly routine to remedy with a course of antibiotics, are becoming increasingly threatening to human health. The reason: antimicrobial resistance (AMR).

Antimicrobial drugs are undervalued for their revolutionary impact on human society. Their discovery in the early 20th century corresponds with a dramatic increase in global life expectancy. Where the world average lifespan would endure just 32 years in 1900, this had jumped to 73 by 2020. Thanks to the development of various classes of antimicrobial agents throughout the last century, death at the hands of bacterial infection has become significantly less of a risk.

However, the emergence of drug-resistant bacteria serves to dilute the effectiveness of antimicrobial agents.

With widespread availability of antibiotics, the risk of overuse, or even abuse of antimicrobials as a treatment option for non-bacterial infections has accelerated the ability of microorganisms to acquire resistance to antimicrobials. The use of antibiotics in animal rearing is also contributing to fueling AMR, as well as antimicrobial residues in the environment.

AMR is responsible for 33,000 deaths per year in the EU. If left unchecked, it could overtake cancer as the leading cause of death in the bloc by 2050. 

- European Commission

While the resistance of microorganisms to antimicrobial treatments is trending upwards, we are witnessing a worrying decrease in novel antimicrobials becoming available to meet patients’ needs.

Incentivising human imperative

This is because the typical business model for pharmaceutical companies to be incentivised by future commercial potential to take on the upfront risk and costs of R&D does not apply in a market where the product must be used sparingly, or else risk being exposed to resistance development. While the humanitarian imperative to produce new antimicrobials weighs heavy, the market incentive does not align.

In response to this challenge, AmCham EU advocates for a three-pronged approach

  1. Preserving the effectiveness of existing antimicrobials by using them more prudently, while also monitoring occurrences of resistance more systematically;
  2. Expanding prevention options, including vaccines and diagnostics medical technologies, to prevent overuse of antimicrobials; and
  3. Incentivising research and development of new antimicrobials by overcoming the lack of ‘pull’ incentives for companies bringing new drugs to the market.  

The time is now for the right package of incentives

The 2021 AMR Preparedness Index highlighted the limited progress made by governments around the world in implementing reforms to incentivise R&D in much-needed novel antimicrobials. Despite the current difficulties, industry is taking action – in the absence of a sustainable, long-term solution and recognising the urgency of the situation, businesses have invested more than $1bn through the AMR Action Fund to help bridge the funding gap and develop two to four new antibiotics by 2030. But work remains to be done. Thus, AmCham EU calls on the EU and the US governments to lead the world through this impending ‘silent pandemic’. Together, they can use their financial firepower and the world-class R&D institutions in their territories to correct the market failure and provide the missing incentives for the development of new antimicrobials that the world needs. The Transatlantic Task Force on Antimicrobial Resistance (TATFAR) is an important forum in this respect. Its ambition to incorporate a ‘one health’ approach to enhance collaboration and strengthen domestic and global efforts to combat AMR is laudable. We look forward to engaging on the TATFAR work plan for the period 2021-2026, which alongside the EU’s Pharmaceutical Strategy for Europe, will be vital vehicles for dialogue between industry and policymakers in finding the right package of incentives to foster R&D in novel antimicrobials.

As AMR continues to undermine modern medicine’s most powerful treatment tools, we must take action. Given the lengthy process of developing, testing and bringing to market a new antibiotic, we no longer have time to waste. The window of opportunity is closing – we need to act now.

About AmCham EU's Healthcare Committee

The Healthcare Committee of AmCham EU contributes to ongoing EU legislative and policy discussions. It provides EU policymakers, institutions and other relevant stakeholders with the perspective of US companies that operate in Europe. Health is an important driver for wealth and economic growth. The Committee therefore supports the EU health agenda towards affordable, sustainable and innovative health systems. Composed of the various healthcare industries (pharmaceuticals, eHealth, medical devices, consumer, and transport industries), it aims to be a reliable policy partner to the EU institutions and to help ensure that new healthcare-related legislations and policies add value to, and benefit, the entire healthcare ecosystem.

Recent work from the Healthcare Committee: