Remko van Leeuwen
Vice President, BEAM Alliance
AMR will not be solved without innovation. No innovation is possible without attractive market conditions. This duality is now well understood by the political world, which has already started to work.
The threat of antimicrobial resistance continues to grow. The number of resistant infections is growing by 20% a year in Europe and is causing the deaths of 79,000 people in OECD and EU countries (and many, many more in developing countries).
Flaws stunting innovation
New innovative approaches are needed to put a stop to this vicious circle. Over 10 years ago, I founded a startup called Madam Therapeutics to develop a new class of antibiotics. I quickly discovered that it is difficult to make money with a new antibiotic. For instance, doctors prefer not to prescribe a new antibiotic as they like to save it for the treatment of a bacterium that is resistant to our standard antibiotics.
It hardly pays to develop antibiotics. Big pharma companies have long since pulled out of the market. Startups and small businesses are struggling. Madam Therapeutics, the company that I founded, survived for over 10 years but was declared bankrupt this summer. Not because we made bad medicines, but because our drugs would not be prescribed. Therefore, investors were not interested. However, new payment models can make the development of an antibiotic attractive again for entrepreneurs like myself.
Over the last 12 months, different countries
have put forward concrete proposals for
financial incentives to resolve the market failure.
Small steps have been made
Over the last 12 months, different countries have put forward concrete proposals for financial incentives to resolve the market failure. Leading the way is the UK, which, on the strength of the experience gathered via a pilot mechanism launched in 2021, is preparing to implement the first permanent subscription instrument.
Japan is launching a pilot scheme to parameterise and size its own instrument. Canada is putting together a proposal based on the UK model and is making rapid progress on its implementation. The US has drafted an ambitious bill, the PASTEUR Act, which is still looking for the right legislative vehicle to be passed by Congress.
EU looking for a way forward
The European Commission has proposed an alternative: the transferable exclusivity extension voucher. The proposal has been heavily criticised, and no other concrete alternative has been put forward. Innovators are gradually going out of business, and the portfolio of products under development is dwindling, hence my call to European politicians: let’s make a move — now. We no longer have time to stall because pathogens don’t.