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Antimicrobial Resistance 2020

The threat of a bacterial pandemic needs a new business model now

iStock / Getty Images Plus / myshkovsky

Thierry Mauvernay

President & Delegate of the Board, Debiopharm

Bertrand Ducrey

Chief Executive Officer, Debiopharm International & Vice-President, Debiopharm

Bacterial infections could become the next pandemic – and we could be helpless because today’s antibiotic development model is broken.

“The World Health Organization (WHO) says 12% of current deaths are due to infections, and an estimated nine different bacteria are developing antimicrobial resistance. By 2050, that could mean 10 million deaths annually at a society cost which could reach $100,000 billion,” says Thierry Mauvernay, President of global biopharmaceutical company Debiopharm. “Unfortunately, the present model of antibiotic development is flawed.”

Antibiotics are currently not profitable

He explains: “Antibiotics typically take an average of 10-12 years to develop and costs are high – between 1 to 2 billion dollars. Meanwhile the purchase price of antibiotics is low, so major pharmaceutical companies have given up on developing new antibiotics because it’s unprofitable.” Therefore, a new business mode is essential.

A new system to incentivise is needed

Instead of the pay-per-box system, Mauvernay suggests an insurance system, where manufacturers receive guaranteed payments, whether or not the drugs are used.

For instance, for a hospital could pay an annual fee, based on the number of beds, for the right to use a targeted antibiotic. The insurance fees could vary according to the wealth of the country. Alternatively, groups of countries or the WHO could buy the licence. People are starting push for this model, says Mauvernay.

New methods to tackling antibiotic resistance bacteria

We need to find new effective antibiotics that work against bacteria resistant to all currently available antibiotics, while preserving indigenous gut microbiota. Debiopharm is currently researching into new antibiotics that inhibit the enzyme FabI, which leads to bacterial cell death.

Three of the most dangerous bacteria that affect our society today include Staphylococcus aureus; gonorrhoea; and Acinetobacter, a gram negative bacteria.

These three bacteria affect 100 million people annually, but some 10% of these infections are already resistant to any treatment. In some countries, gonorrhoea is resistant to seven of the eight existing treatment. In other countries Acinetobacter is 100% resistant.

We need to continue researching and development new antibiotics for this type of infection, so doctors use non-specific antibiotics. A new targeted product will prevent AMR.

It’s time to act in partnership

“A public-private partnership to co-finance antibiotic development is the solution,” says Mauvernay. “A global research fund of 15 to 20 billion francs over ten years could fund the development of 10 to 20 new classes of antibiotics. At the global level this is a small amount – especially compared with the cost of COVID-19”.

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