Dr Hanan Balkhy
Assistant Director-General for Antimicrobial Resistance, World Health Organization
Dr Manica Balasegaram
Executive Director, Global Antibiotic Research and Development Partnership
COVID-19 has made it clear our health and wellbeing are inextricably linked regardless of where we live. It has also demonstrated that unlocking global cooperation and investment cannot wait for a threat to emerge.
Unlike the novel coronavirus, which required bold, reactive efforts to identify medical countermeasures, there are too few promising solutions in the antibiotic pipeline. WHO warned in its ‘Antibacterial Pipeline Report’ that the drug development landscape was insufficient to address drug resistance. This is due to several factors, including the lack of profitability for developing new antibiotics. Commercial constraints discouraged private investment in preparing for pandemic threats. Tackling the threat of drug-resistant infections requires proactive funding and global cooperation within a One Health framework.
WHO warned in its ‘Antibacterial Pipeline Report’ that the drug development landscape was insufficient to address drug resistance.
Comprehensive approaches and equitable access
What do we mean by One Health? It is an approach to designing and implementing programmes, policies, legislation and research in which multiple sectors work together to achieve better outcomes. This is critical for tackling the pandemic of drug-resistant infections, which moves silently between humans, animals and environments.
Treatments will only be successful if antimicrobials are available to everyone, including in low- and middle-income countries, and used responsibly and appropriately. While the public and private sectors have worked flexibly during COVID-19, there have been significant challenges to equitable access to medical countermeasures. This will delay the end of the pandemic. Such inequity should not be a feature of the response to drug-resistant infections. Furthermore, the reality and know-how of low- and middle-income countries must be a part of a comprehensive response.
Global partnerships for a global crisis
One way to proactively address drug-resistant infections, to assure sustainability, equitable access and stewardship, is through not-for-profit partnerships. Such partnerships, unconstrained by commercial profitability requirements, can invest in preparing and responding to drug-resistant infections according to public health needs.
These partnerships are well positioned to work with public and private sectors to develop and provide new antibiotics for those that need them, wherever they live. They can also work with governments, companies and communities in all countries. Yet to succeed, this work must be significantly scaled up now.