The World Health Organization (WHO) has identified Antimicrobial Resistance (AMR) as one of the top 10 global public health threats. This issue arises from the spread of drug-resistant pathogens, which makes treating common infections a serious challenge. An even greater concern is the emergence of bacteria that are resistant to multiple or all existing anti-bacterial agents. As these bacteria continue to spread, there is an urgent need for the development of new antimicrobial solutions
One of the obstacles to ensuring effective treatments is the lack of basic education concerning their proper use. Kevin Outterson, a law professor at Boston University and executive director of CARB-X, pointed out this issue during an interview with pharmaphorum. He stated, "The more we use or waste antibiotics, the faster resistance develops. Bacterial resistance inevitably progresses."
The critical point here is that the more antibiotics are misused, the worse the resistance situation becomes. The Mayo Clinic reports that the overuse of antibiotics is a significant problem, which already causes approximately 1.2 million deaths globally each year. Without effective action, this figure is expected to reach 10 million deaths annually by 2050. The growing inefficacy of antimicrobials, including antibiotics, antivirals, antifungals, and antiparasitics, stems from various factors, including the natural evolution of organisms to withstand medication.
Certain actions directly within people's control contribute to the increasing rate of AMR. These actions include the misuse and overuse of antimicrobials, inadequate access to clean water, sanitation, and hygiene for humans and animals, poor infection and disease prevention in healthcare facilities and farms, limited access to quality and affordable medicines, vaccines, and diagnostics, lack of awareness and knowledge, and insufficient enforcement of legislation, according to the WHO.
Why is AMR a threat?
Antimicrobial resistance is a rapidly growing problem that already claims over a million lives every year. The situation is urgent, but finding a sustainable solution is challenging. Alexander Fleming discovered the world's first antibiotic, penicillin in 1928, yet mass production did not begin until the 1940s due to various difficulties. The significance of antibiotics in modern medicine is well-established, as they have saved countless lives. Prior to their discovery, even minor infections were deadly, and the average life expectancy was only 47 years. Despite all the medical advancements made since the introduction of antibiotics, a world without effective antibiotics would lead to a decline in life expectancy by 20 years.
The risks associated with a world without effective antibiotics are significant. However, the rise of antimicrobial resistance (AMR) is currently a major concern. To address this, $100 million has been allocated this year to companies developing antimicrobials through clinical trials.
On the other side of this issue, some countries are implementing alternative payment models for antimicrobials. Kevin Outterson mentioned a program established in England as an example. Known as the "Netflix subscription" for antimicrobials, it involves a fixed annual fee of £10 million. Regardless of the number of medications administered to patients, two antibiotics will be paid for over a 10-year period. The UK's model is intended to replenish the pipeline of antimicrobials, which is necessary to avoid a potential catastrophe beyond the current pandemic.
Developing new strategies to combat AMR has resulted in various approaches, including pharmaceutical companies pooling their resources to support early-stage biotech firms working on treatments for drug-resistant infections. Additionally, countries are reevaluating reimbursement strategies for antimicrobial products. The AMR Action Fund, for instance, has selected two biotechs to receive funding for their work in this field. Beyond these two, the Fund plans to invest over $CARB-X.
CARB-X is a non-profit partnership aimed at accelerating the development of antibacterial products. Based at Boston University, CARB-X receives funding from various countries and partners such as the Wellcome Institute, UK Aid, and the US National Institute of Allergy and Infectious Diseases, among others. Their work is essential as the clinical pipeline for new antimicrobials has significantly reduced. CARB-X supports early-stage development, particularly until the phase 1 stage, when additional private or public support must be secured for commercialization. This financial aspect is where progress can become challenging.
The lack of progress is due, in part, to misuse of treatments when they are unnecessary or inappropriate, with one-third of people wrongly taking medication. It is also essential for people to complete the full course of treatment as prescribed, as stopping prematurely can contribute to the development of antimicrobial resistance.
Outterson outlined the necessary short-term actions to counter AMR, saying, "First, stop wasting these drugs. Use them only when necessary to protect our health. Second, prevent infections whenever possible, including through vaccination. And finally, conduct research today for future antibiotics. That is our mission at CARB-X."
Original Article.
