Antimicrobial resistance (AMR) is a naturally occurring phenomenon that is being accelerated by poor stewardship of antibiotics in healthcare and farming. If antibiotics continue to lose their effectiveness, then commonplace medical interventions could become extremely high risk, undoing decades of progress in public health.
Moreover, antibiotic-resistant infections are difficult to treat or untreatable. They already account for c.700,000 deaths per year globally1, and they are increasing healthcare costs.2 AMR therefore threatens our entire healthcare ecosystem, including hospital operators and health insurers.
More research required
Since 1990, 78% of major pharmaceutical companies have scaled back or cut antibiotic research due to development challenges.3 Via our engagement and research, we have sought to understand pharmaceutical companies’ perspective on the steep decline in antibiotic research. The fundamental challenges are:
- Scientific: It is extremely difficult to find substances which kill bacteria or prevent them from spreading and are non-toxic to humans. Fewer than 1 in 70 antibiotics reach patients.4
- Economic: Antibiotic R&D is expensive and (for various reasons) antibiotics do not command high prices. To compound matters, stewardship measures limit their use in order to preserve their efficacy.
In order to fix the broken market and rescue the antibiotic pipeline, more incentives are needed, such as market entry rewards and changing how pharmaceutical companies are paid for access to antibiotics.
Responsible manufacturing & stewardship
Responsible manufacturing and product stewardship are also key to addressing AMR. In our engagement, we used the relevant metrics in the Access to Medicine Foundation’s Antimicrobial Resistance Benchmark to ask targeted questions.
Shionogi and GlaxoSmithKline, two major pharmaceutical companies we’ve engaged, are taking positive steps towards good antibiotic stewardship. Progress is accelerating, but we need all companies for which AMR is a material business risk to work towards implementing best practices.
Moreover, pharmaceutical companies’ efforts to meaningfully contribute to the war against AMR must go hand-in-hand with solutions to reduce the need for antibiotics in the first place. Each year, there are 47 million unnecessary antibiotic prescriptions written in US doctors’ offices and emergency departments.5