World Economic Forum, Davos: New Antimicrobial Drugs

Submitted by GAtherton on 25 January 2016

Leaders of the world attending the current economic forum at Davos-Klosters, Switzerland are well used to discussing subjects that affect all of us. This week they are being asked to consider the emerging difficulties in healthcare caused by the gradually reducing efficacy of many of our antimicrobial medications. Microbes are becoming resistant to many (most) of the commonly used drugs, new drugs are desperately needed. In addition we may be able to slow down the development of resistance to existing and new drugs if we are far more careful and sparing with the use of these medications.

It is not just use of these drugs in the clinic that is important, it turns out that huge amounts of very similar antimicrobial drugs are used by our farmers to prevent crops being spoiled and boosting the growth of livestock. This has led directly to more resistant microbes in our environment which can and do cause resistant infection. Use of antimicrobials by farmers also needs to be reduced to slow down the march of resistance.

In this situation we would usually look to those companies who develop drugs to invest in finding and manufacturing new antimicrobials, however if all of the above measures to reduce use of new and existing antimicrobial drugs are put into place it also means that much less drug will be needed resulting in a much smaller market for pharmaceutical companies to use to make profits. Investors in drug companies are much less likely to want to put money into drugs that have limited markets when there are much more profitable alternatives available, consequently if we leave the production of new antimicrobial drugs to free market forces fewer drugs will be developed.

Most of the major pharmaceutical drug companies who have an interest in the development of antimicrobial drugs have signed up to a declaration that was presented to the economic forum on 21st January 2016. In it the companies ask for governments to work with them for the development of new antimicrobial drugs.

These mechanisms are needed to provide appropriate incentives (coupled with safeguards to support antibiotic conservation) for companies to invest in R&D to overcome the formidable technical and scientific challenges of antibiotic discovery and development. These include mechanisms to ensure that, where appropriate, the pricing of antibiotics more adequately reflects the benefits they bring; and novel payment models that reduce the link between the profitability of an antibiotic and the volume sold. An integral part of these models is a reduced need for promotional activity by companies.

In return the companies make the following promises:

·       Reducing the development of drug resistance. The companies commit to encouraging better and more appropriate use of new and existing antibiotics, including through work that supports the antibiotic stewardship principles set out by the World Health Organization (WHO) Global Action Plan on antimicrobial resistance (AMR), and via improved education of clinicians. This support extends to promoting more judicious use of antibiotics in livestock, as part of a ‘one health’ approach.

·       Increasing investment in R&D that meets global public health needs. Recognising the need to increase research into new antibiotics, diagnostics, vaccines and other alternative treatments, the companies commit to a continuation and extension of collaborative initiatives between industry, academia and public bodies to improve how R&D in the field is done and provide greater opportunities for the scientific barriers to antibiotic discovery to be overcome.

·       Improve access to high–quality antibiotics for all. In light of the gaps that remain in global access to our existing antibiotics and vaccines, and the importance of ensuring that new generations of products are available to all those who need them, the signatories commit to supporting initiatives aimed at ensuring affordable access to antibiotics in all parts of the world, at all levels of income.

Once these principles are in place, we must hope a new era of public/private investment will encourage better provision of these vitally important drugs for everyone throughout the world.