Stepping up to the plate on antimicrobial resistance

IFPMAEduardo Pisani, Director General of IFPMA – the International Federation of Pharmaceutical Manufacturers and Associations.

Antibiotics have made modern medicine possible. Before the discovery of penicillin in 1928 and the recognition of its therapeutic potential, there were few tools doctors could use when patients came to them with common or minor infections from simple paper cuts. Today, complex medical interventions are made possible by the use of antibiotics.

However, seventy years on, the rise of antimicrobial resistance (AMR) is threatening the effectiveness of these tools. A hallmark of antibiotics is that they lose their effectiveness over time as bacteria naturally evolve and mutate and so become resistant to the medicine’s power.  Estimates from the UK Review Team on AMR predict that the death toll from drug-resistant infections could rise from 700,000 today to 10 million by 2050, and that the burden put on healthcare systems would amount to trillions of dollars.

These statistics and scale of the challenge of tackling antimicrobial resistance may seem daunting, but they have certainly galvanised action. In many ways, the global pharmaceutical industry is already at the forefront of leading action to address antimicrobial resistance.

In January this year, a major milestone in the global response to AMR was achieved, when over 100 companies and 13 associations signed the Declaration by the Pharmaceutical, Biotechnology and Diagnostics Industries on Combating Antimicrobial Resistance. The Industry Declaration set out three key commitments. First, to reduce the development of drug resistance; second, to increase investment in R&D to meet global public health needs; and third, to improve access to high-quality antibiotics and vaccines for all. The industry also called on governments to commit to allocating the funds needed to create a sustainable and predictable market for these technologies while also implementing the measures needed to safeguard the effectiveness of antibiotics. There is a clear need for global coordination of stewardship, conservation, hygiene, and the creation and use of new commercial and incentive models for antibiotics, vaccines and diagnostics, to be delivered through local action.

The Declaration is a living document, and to keep up the pace with the evolving landscape of scientific breakthroughs and policy action, it will be updated every two years. Alexander Fleming himself is said to have called the discovery of penicillin “a triumph of accident”. Since, we’ve moved from analyzing basic samples of mold to developing new molecules through innovative private-public partnerships. As bacteria are getting “smarter”, researchers spend hundreds of hours in the lab to develop new medicines to address drug resistance. With 34 antibiotics and infection preventing vaccines within the global pipeline, the opportunity to bring resistance under control is within reach.

In one of the most comprehensive analyses to date on the scope of drug resistance, the World Health Organization points out that there are major gaps in actions needed across all 6 regions in order to prevent the misuse of antibiotics and reduce the spread of antimicrobial resistance. Perhaps one of the most eye-opening findings is that few countries (34 out of 133 surveyed) have comprehensive national plans to tackle AMR. While antibiotic resistance is a serious global threat, it does not provoke the same sense of urgency for all countries.

It is evident that there is no “one-size-fits-all” approach, and that governments need to acknowledge the global principles for action and implement them at local level. There are some countries that are already leading the way, but not all may start from the same level playing field. In Europe, there are countries such as Sweden, the Netherlands or the UK, who have invested in taking concrete actions to meet ambitious targets on AMR. In Africa, for instance, there is a real need for more and better data to understand the magnitude of AMR, while China is looking to increase training for consumers and medical professionals on proper use of antibiotics. Furthermore, the IFPMA Health Partnerships Directory lists over 20 case-studies of collaborative initiatives to combat AMR.

These issues are at the top of agenda of the forthcoming UN High-Level Meeting on AMR, where UN member states will be summoned to maintain a strong political commitment to tackle this global health threat.

IFPMA has an event in the margins of this meeting, where we will discuss how the biopharmaceutical industry will deliver on the commitments laid down in the Declaration. Building on the Declaration, over a dozen leading biopharmaceutical companies have developed a roadmap which lays out a number of practical steps in four key areas: reducing manufacturing pollution; addressing inappropriate use; improving global access; and developing a broad R&D ecosystem. Without collective action and local implementation of plans, we cannot expect real change. But when the global community rolls up their sleeves, we are that much stronger in tackling AMR.

Useful links

Antimicrobial resistance: millions of lives and trillions of dollars? Jim O’Neill, Commercial Secretary to the UK Treasury, author of the Review on Antimicrobial Resistance

Tackling antimicrobial resistance Michele Cecchini, OECD Health Division

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  1. Patricia Almeida Ashley - 17/09/2016 Reply

    Dear Mr. Eduardo Pisani, Director General of IFPMA

    I congratulate the global awareness campaign on AMR and the initiative of the Declaration by the Pharmaceutical, Biotechnology and Diagnostics Industries on Combating Antimicrobial Resistance.

    Indeed it is a very risky situation for all in every place of the world, regardless of income, educational background, ethnic origin and, mostly, regardless of the level of access to social, cultural, economic and environmental human rights.

    Analysing the current situation for taking steps to build safe procedures to prevent AMR is meritorious, as we see from your article announcing the global Declaration by over 100 companies and 13 associations of the International Federation of Pharmaceutical Manufacturers and Associations and, moreover, the realization of an specifc global UN meating to engage UN country members at the UN High-Level Meeting on AMR. I see both as a clear picture of pharmaceutical industry access to public policies and government decisions arena.

    Would there be a chance, my guess is that it is a rather challenging one, of the Antibiotic Economy to turn their research and demand for funds from Government to invest further in:
    – Education for all
    – Sanitation for all
    – Gender equity and protection to families
    – Quality of labour environment and time for families and leisure and affective and communitary relationships
    – Food, of good quality and without toxines from pesticides and chemicals that intoxicate humans and the environment
    – Fresh and good quality of water
    – Sustainable cities
    – Equitable access to good quality public transport
    – Guidance to healthy nutrition, especially those diets and nutrients which contribute for our microbiota in our intestines
    – No propaganda for alcohol as a symbol of value for social relations
    … and so many more suggestions that promote qualify of life, time, kindness, peace, affection and that stimulates new concepts of Health, Sickness and Cure, promoting natural defenses in our human and living environment?

    I am talking of themes which are part of the Agenda 2030 for Sustainable Development, approved by the UN Assembly in september 2015. Policy coherence for the implementation of the Agenda 2030, as well as other complementary agendas at global level, as the Finance for Development Agenda, the Open Government Partnership, the Climate Change Agenda and others. How could the pharmaceutical industry move towards sustainability transformation, which requires people, planet, prosperity, peace and partnership?

    To keep thinking ahead in measures which depend on public and global funding from inside the same systemic global, national, subnational organizational and communitarian/family/individual model that have generated the ‘problem’ of AMR (which includes the roles and powers of pharmaceutical companies, health and medicine industries and academia, graduated professionals and researchers in higher education funded by the system and educated by these same concepts, demanding according government policies and ‘funding’) shall not resolve or even transformate the whole totality of the ‘problem’ of AMR. Just because AMR is the tip of the iceberg based on parcial and fragmented concept of human beings, humanity, nature, thus affect economy, cultures, politics, policies and fundings for the concept and principles it is rooted.

    May I suggest a recent reading for industry and UN debate from research group from Leuphana University, in Germany, which is the leverage points theory towards sustainability transformation (see at and the paper: Abson, D.J., Fischer, J., Leventon, J., Newig, J., Schomerus, T., Vilsmaier, U., von Wehrden, H., Abernethy, P., Ives, C.D., Jager, N.W. and Lang, D.J., 2016. Leverage Points For Sustainability. Ambio, pp.1-10.

    I would mostly be grateful if you personally have a look at the paradigm of sustainable development and sustainability perspective.

    My heart to your heart, my mind to your mind, my hands to your hands, our joint steps.

    I wish you all the best.

    Patricia Almeida Ashley
    Associate Professor
    Núcleo Girassol de Estudos em EcoPolíticas e EConsCiencias
    Universidade Federal Fluminense
    Niterói – Rio de Janeiro State – Brazil

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