[Ip-health] Guardian: No antibiotics without a test, says report on rising antimicrobial resistance

Thiru Balasubramaniam thiru at keionline.org
Sun May 22 03:46:35 PDT 2016


Sarah Boseley Health editor

Thursday 19 May 2016 00.01 BST

Last modified on Thursday 19 May 201609.58 BST

A blueprint to end the scourge of antimicrobial resistance proposes that
drug companies should foot the bill for the development of new antibiotics
and that patients should not be able to get them without a test to ensure
they are needed.

Economist Jim O’Neill, charged two years ago by David Cameron with finding
answers to one of the most pressing problems in the world today, says the
global financial cost of no action would be the loss of 10 million lives a
year by 2050 and £69tn ($100tn) a year.

“One million people have died while we have been doing this review,” said
Lord O’Neill, who became a minister while completing the report. Without
action, he said, there would be more people dying in the future than are
dying of cancer.


The two most eye-catching proposals advanced by O’Neill are:

To force the pharmaceutical industry to “pay or play”. Drug companies must
either research and develop new antibiotics or be prepared to fund other
companies to do so. “We think there is a credible case for the
pharmaceutical industry itself to pay, given how important antibiotics are
for 7 billion people around the world,” he said.
To ban doctors from prescribing antibiotics until they have carried out
rapid tests to prove the infection is bacterial. “We must stop treating
antibiotics like sweets, which is what we are doing around the world
today,” he said. However, there must be incentives to develop such tests
which do not yet exist.

The pay or play idea was immediately rejected by trade body the Association
of the British Pharmaceutical Industry. “[It] fails to recognise the need
for a collaborative response which this long-term review has consistently
identified,” said Dr Virginia Acha, director of research, medical and
innovation at the ABPI. “Putting the onus on any one group will not solve
the problem and is not a sustainable solution.”


Companies already involved in antibiotic research were less hostile. Sir
Andrew Witty, GlaxoSmithKline’s chief executive, called the report helpful
and added: “Governments, industry and other relevant groups must now work
together to develop these ideas into practical steps that encourage and
reward further research and ensure a supply of effective new antibiotics
for future generations.”


That would be an incentive for industry to invent the rapid diagnostic
tests needed and a new Global Innovation Fund worth $2bn over five years
would help pay for this and other research. Low and middle-income countries
should be subsidised to buy the tests.

There must be urgent action to stop the use of highly critical antibiotics
in animals, which are the last line against infection in humans, said the
report. Recently bugs resistant to Colistin, one of the antibiotics of last
resort, were found in China, where the drug has been used in farm animals.


O’Neill, now a minister in the Treasury, is looking to the G20 meeting in
China and a special session of the UN general assembly to take the
proposals further.

The man he described as his boss, the chancellor, George Osborne, was one
of those who applauded the report, saying that antimicrobial resistance “is
not just a threat to health but also to the world economy. Apart from the
moral case for action of the sort Lord O’Neill proposes, the economic cost
of failing to act is too great to contemplate.”

Margaret Chan, director general of the World Health Organisation, called it
“a thorough and compelling review” which tackled “the burning need to find
incentives that can get new products into the pipeline”.

More information about the Ip-health mailing list