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At BMO GAM we have been engaging companies on AMR since 2019. WAAW is an opportunity to take stock of and re-cap our engagement over the past two years. Please refer to our Viewpoints and Whitepaper at the end of this article if you are interested in learning more.
AMR in brief
AMR is a natural phenomenon in which microorganisms develop resistance to antimicrobial agents. However, it is being accelerated by poor stewardship of antibiotics in healthcare and farming: antimicrobial-resistant microbes can spread between people and animals, and from person to person. As a result, a growing number of common bacterial infections – including urinary tract infections, gonorrhoea, tuberculosis and pneumonia – are becoming increasingly difficult to treat.
COVID-19 could be accelerating AMR
Unfortunately, evidence suggests that Covid-19 has increased inappropriate antibiotic use. According to a study of COVID-19 patients, mostly in Asia, 70% of patients received antimicrobial treatment, despite – on average – only 10% having bacterial or fungal coinfections. The Covid-19 pandemic could therefore be accelerating AMR, which – according to the World Health Organization (WHO) – is one of the greatest threats facing humanity. Against this backdrop, we need more urgent action to avert another public health crisis: according to a landmark 2014 review sponsored by the UK Prime Minister and the Wellcome Trust, if left unchecked, AMR could lead to the number of deaths from drug-resistant infections rising from approximately 700,000 today to 10 million by 2050, potentially reducing global GDP by 2-3.5%.
AMR is a natural phenomenon in which microorganisms develop resistance to antimicrobial agents. However, it is being accelerated by poor stewardship of antibiotics in healthcare and farming: antimicrobial-resistant microbes can spread between people and animals, and from person to person. As a result, a growing number of common bacterial infections – including urinary tract infections, gonorrhoea, tuberculosis and pneumonia – are becoming increasingly difficult to treat.
Our engagement
Our engagement on AMR is aligned with the WHO’s “One Health” philosophy. AMR is a highly complex threat, with root causes in a variety of sectors – our engagement has therefore taken a cross-sector approach, encompassing:
- Pharmaceutical companies
- Animal protein producers and purchasers
- Animal health companies
- Diagnostics companies
- Water utility companies
In total, from May 2019 – October 2021, we engaged over 60 companies on AMR.
In 2019, we focused on animal protein producers and purchasers (“food companies”) and pharmaceutical companies, recognising that their business models are – relatively speaking – highly dependent on effective antibiotics. Where relevant, we leveraged the research of the FAIRR Initiative and the Access to Medicine Foundation: these organisations are evaluating how food and pharmaceutical companies are taking steps to address AMR, respectively. One conclusion from this phase of our engagement is that progress on addressing AMR is accelerating; however, food and pharmaceutical companies are still on a fairly wide spectrum in terms of implementing best practices.
To access examples of best practices, download our whitepaper: Antimicrobial resistance: overcoming challenges.
Of course, we recognise that best practices will evolve as scientific knowledge of AMR increases and AMR data collection efforts ramp-up. In the meantime, transparency on initiatives to tackle AMR and – for food companies – antibiotic usage in different species, is absolutely key.
As drug developers and major suppliers of antibiotics to animal protein producers, animal health companies bridge the gap between pharmaceutical companies and food companies. At present, animal health companies’ efforts to combat AMR are mixed: some are channelling more resources towards antibiotic alternatives, especially vaccines, but there are significant gaps in the oversight of their suppliers’ (the antibiotic manufacturers) management of environmental risks, and inconsistent messaging in antibiotic sales and marketing materials.
Our most recent – and ongoing – engagement on AMR is targeting diagnostics companies and water utility companies. AMR diagnostics is a burgeoning area: we recognise that they can play a vital role in preventing the misuse of antibiotics by enabling more accurate therapy decisions, thereby reducing the risk of AMR. Via our research and engagement we are aiming to hone in on leaders in the development of products to identify, monitor, screen for and prevent resistance. Finally, we recently initiated dialogue with water utility companies headquartered in the US and the UK. We are seeking to understand their perspective on emerging methods to identify and remove antibiotic resistant bacteria (ARB) and genes (ARGs) during wastewater treatment to prevent their dissemination in the environment.
Final thoughts
Ultimately, we need companies in all of the sectors mentioned above to continue to drive forward initiatives to counter the threat of AMR, and they need the support of governments, investors and civil society: we all have a role to play. Together we can keep antibiotics working.
Interested in learning more about AMR and our engagement on this issue? Catch-up on our insights and engagement progress using the links below.
ESG Viewpoint – Antimicrobial resistance and the animal health industry
We explore some of the key points and case studies in FAIRR’s Feeding Resistance: Antimicrobial stewardship in the animal health industry report
Whitepaper – Antimicrobial resistance: Overcoming challenges
An in-depth assessment of why AMR is a highly material issue for food and pharmaceutical companies and how they are tackling it
ESG Viewpoint – Antimicrobial resistance – an investor perspective on a pressing global threat
An overview of the first phase of our engagement with animal protein producers and purchasers and pharmaceutical companies
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Get to know the author
Catherine McCabe, Analyst, Responsible Investment
Catherine joined the Responsible Investment team in 2018, and currently covers engagement on public health issues. She also leads work on BMO GAM’s Responsible product range. Outside of work, Catherine enjoys listening to podcasts about science and history, and hiking in the Alps. She speaks German and Italian because she studied both languages at university.
