[Ip-health] IP-Watch: Antibiotic Resistance “Already Here” And Pipeline Is Dry, UK Health Minister Tells UN

Thiru Balasubramaniam thiru at keionline.org
Wed Jun 8 07:20:32 PDT 2016


Antibiotic Resistance “Already Here” And Pipeline Is Dry, UK Health
Minister Tells UN


NEW YORK — An estimated one million people may already die each year
because they are resistant to all known antibiotics, and the number could
reach 10 million per year and devastate the world economy by 2050 unless
key steps are taken, experts from the United Kingdom and South Africa told
a press briefing on antimicrobial resistance at United Nations headquarters

“It’s already here. This is not a problem for the future,” said Prof. Dame
Sally Davies, chief medical officer for England. “This is a real worry.”

Davies was joined at the press briefing by Lord Jim O’Neill, chair of a
much-discussed review of anti-microbial resistance, and Aaron Motsoaledi,
minister of health of South Africa and chair of the Stop TB Partnership.

The focus of the effort is on a Review on Antimicrobial Resistance led by

Bacteria multiple every 20 minutes so drug-resistant mutations can spread
quickly, said Davies. Even more concerning, bacteria that develop the
resistance will put out a little tube to neighbouring bacteria to give them
the resistance as well.

Meanwhile, all of the available drugs date back to the 1980s, so there is
what Davies called a “discovery void.”

“We have essentially a dry pipeline,” she said, so extra care needs to be
taken to ensure people do not develop resistance to existing antibiotics.

So far, more people still die from not getting access to antibiotics than
from resistance, she said, making “appropriate access” important.

Failure to solve the AMR question will mean failure to achieve the 2030
Sustainable Development Goals (SDGs), she added.

One of the purposes of those involved in the effort is to “make a lot of
noise,” O’Neill said. They are seeking to raise the level of awareness of
the problem to that of smoking, and are undertaking a global awareness

The issue is gaining ground at the highest policy levels, the speakers
said, as it is expected to be addressed at upcoming G20 meeting to be held
in China (and beginning with a G20 “sherpas” meeting later this month at
which finding ways to pay is on the table).

It then will be the subject of a UN High-Level Meeting on 21 September,
only the third meeting ever dedicated to a health issue (AIDS,
non-communicable diseases). The high-level meeting could address issues
such as stewardship and reducing the use of antibiotics in agriculture for
animals consumed by humans.

The report details the lack of research and development into new
antibiotics and suggests a way to address the shortcoming but creating a
system of market entry rewards that would more fully reward products most
valuable to society. The report also mentions patents and says the system
would de-link the price of the products from the cost of R&D, with
successful companies agreeing to make it accessible to the developing world
at the “right” price, as O’Neill put it in the press briefing.

The annual World Economic Forum in Davos signed an agreement on this, he
noted. The delinkage principle is “broadly accepted” by industry, he said.
What is being debated is incentive.

O’Neill: Huge Return on Investment in Antimicrobials

O’Neill led the review which came up with 29 recommendations he said would
solve the AMR problem if followed. They would cost some $40 billion, but
would save the world from the “devastating reality” and a potential $100
trillion cost if AMR is not solved by 2050.

The world economy is now about $70-80 trillion per year, he said, and grows
over time by about 3-4 percent. But AMR would undermine this. He also said
the return on the $40 billion investment gives a “2.5 thousand” percent
return. “That’s an investment fund I’d like to run,” O’Neill remarked.

The report offers alternative ways to come up with the $40 billion, not all
from the public sector, and includes funding for research into new drugs.
This report was also a hot topic at the 23-28 May World Health Assembly.

O’Neill in 2001 coined the term “BRICS” when he showed that Brazil, Russia,
India, China and South Africa (BRICS) could be economically bigger than the
Group of 7 (G7) by 2050.

He said that unsolved, people would no longer be able to have procedures we
now “see as our right,” such as repairing cataracts, having caesarean
births, or knee replacements, for example.

There is a “high likelihood” of an agreement at the high-level meeting in
September, but it remains to be seen how “bold” it will be, he said.

Minister Motsoaledi talked about the effort against tuberculosis as an
example. He said at current rates, efforts to stop TB could take some 180
years, and that more people are developing drug-resistant TB. In some
countries, treating drug-resistant TB – which has only a 50 percent cure
rate and involves a mix of toxic drugs – is eating up budgets.

Motsoaledi added that more research is needed in order to get away from a
broad spectrum antibiotic, which he compared to firing scattershot all over
the forest in order to hit one target. He also said developing countries
need to strengthen their health systems in order to be able to respond to
these threats.

O’Neill said they urge that by the end of this decade, no antibiotics be
given without proper tests.

“Many of these things are doled out like sweets,” he said. “We need to stop
[doing that].”

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