Dr Manica Balasegaram
Executive Director, Global Antibiotic Research and Development Partnership (GARDP)
Drug resistance has been identified by the WHO as among the biggest threats to health and development. However, few new antibiotics are being developed, with half of all treatments used today discovered during the 1950s.
While drug resistance occurs naturally over time, a number of factors have increased resistance in bacteria. These include overuse and misuse of antibiotics in humans and animals, as well as in food production, poor infection prevention and control, and lack of affordable access to medicines. The challenge requires a wider solution than just developing new drugs if we are to prevent the estimated 700,000 deaths worldwide every year as a result of AMR.
Tackling this global public health challenge cannot be solved by one country, organisation, stakeholder or actor alone; this can only be addressed through a global, multi-sectorial approach based on partnerships that bring actors who complement each other together.
A public–private partnership approach
Making new treatments available for every person who needs them requires a partnership approach with both the public and private sectors. The private sector brings significant innovation and experience in the development and delivery of treatments. However, a purely market-driven approach has not produced enough new antibitotics.
Public sector involvement is needed to identify public health needs, set priorities, inject funding and re-shape incentives for the private sector. Public-private partnerships can leverage the best of both sectors and provide a transparent vehicle for collaboration, focused on achieving a mutually beneficial objective to make infections treatable for everyone, everywhere.
Accelerating new treatments for infections
In fact, the Global Antibiotic Research and Development Partnership (GARDP) was created to address this global challenge, and is actively driving R&D into treatments in late-stage clinical development that target priority pathogens identified by the World Health Organization, the needs of priority diseases and populations, while promoting responsible use and affordability to all in need – an area where few others are active.
After three years, GARDP has built a pipeline to address infections in children, hospitalised adults and sexually-transmitted infections.
While the burden is highest among vulnerable populations – women, children, the elderly, immuno-compromised people and those in countries with weak health systems – AMR can affect anyone, of any age in any country. Focusing on children is important and reflects the fact that, while significant progress has been made in recent years to improve child health globally, death in newborns represents 44% of all deaths in children under the age of five.
In Europe – the richest part of the world – research shows drug-resistant infections are responsible for an estimated 2,300 disability-adjusted-life-years per 100,000 people every year. And the burden, which is highest in infants under one, has increased significantly since 2007. Of further concern is the estimated 214,000 deaths in newborns attributable to drug-resistant infections.
What needs to happen globally for AMR?
Several countries are already showing strong leadership and financial commitment towards addressing this global health and development crisis by supporting initiatives that have been launched to reinvigorate the antibiotic R&D pipeline over the last few years. Despite this, more can and must be done to significantly scale-up our efforts to address the magnitude of the public health challenges we face today and ensure these efforts sit within a public-health focused R&D framework.