This month, Innovate UK welcomes the global AMR community, which is dedicated to combating drug resistance.
Innovate UK is delighted to host over 200 of the world’s AntiMicrobial Resistance experts during a three-day virtual event from 10-12 May. The AMR Innovation Mission to the UK 10 - 12 May 2021 is aimed at creating connections and partnerships, to collectively try and conquer this silent, other, pandemic caused by superbugs becoming resistant to drugs.
A global crisis
Imagine a global health crisis in which last year, 700,000 people, including 200,000 newly borns, died. Imagine that total number increasing to 10 million by 2050 (according to the World Health Organisation) if nothing is done. Imagine the drugs that are in use becoming less and less effective and not enough new ones being developed. Frightening, right? I am not talking about coronavirus or Covid-19. No, I am talking about a silent killer. One that isn’t about one bug travelling rapidly around the world, catching global headlines and where rapid vaccine development offers hope. I am talking about the world of drug resistant superbugs. Scientists call it AntiMicrobial Resistance (AMR). AMR is about dangerous micro-organisms (not just bacteria, but also fungi, parasites, and yes, also viruses) becoming resistant to medication, to the point where no drugs are available at all. Drug-Resistant Tuberculosis (DRT) alone now kills 250,000 people annually.
Many of these drugs are essential to being able to operate. And it is a crisis that not only affects humans; it also affects the wider animal world. AMR is a global crisis which is in the shadows of Covid-19 and largely forgotten, but which is having increasingly dire consequences for human and animal health.
Why are companies not solving the problem?
So why aren’t companies developing new drugs or coming up with other new solutions? We have all followed the fantastic progress scientists and businesses have made with getting a coronavirus vaccine developed in record time (much of the science in the UK was funded by UKRI by the way). Why isn’t something being done about AMR?
The answer is complex. Some of the answer lies in the variety of resistant bugs out there, some about how humans use existing drugs and a lot of it is to do with the economics of antimicrobial medicines. AMR is not just about one bug, but about many different ones, all with their own specific disease characteristics and needing different drugs. Humanity has been pretty careless about the drugs that were developed. Those of you with children know how doctors are under immense pressure to prescribe antibiotics to despairing parents with coughing children, when very often the symptoms are caused by the common cold and we all know antibiotics are not useful against it.
In many countries around the world, antibiotics are on the shelves next to paracetamol and other over the counter medication. Our attitude to antibiotics is reckless and we are now seeing the effects of this mismanagement.
The economics of antibiotics do not help. A lot of the drugs being developed are not in areas of immediate need. Those that are still face relatively low sales volumes, partly because doctors need to keep new drugs back to avoid the same misuse that rendered previous incarnations ineffective. Antibiotics are mostly cheap generic products, so there isn’t much of a reason to be careful with them, leading to overuse and misuse. Moreover, relative to blockbuster drugs for cancer or heart disease, the number of infections is still relatively small (but growing) and treatment durations are short. The financial case for companies to develop new antimicrobials and invest in expensive R&D is, therefore, pretty weak.
What is being done
Luckily, governments around the world, supported by international organisations such as the World Health Organisation, are now waking up to the problem and are taking action. The latest progress report by the World Health Organisation (albeit based on countries’ self-assessment), suggests governments are starting to take action. The current COVID-19 pandemic has opened our eyes to the disastrous effects of inaction and procrastination. The success of the development of corona virus vaccines and the collective action in terms of social distancing, lockdowns and mask wearing has shown what can be done in a relatively small timescale and if we all pull together. I am proud to say that the UK Government has been and still is, at the forefront of this concerted international effort.
The action plan to combat AMR focuses on a number of areas:
1) Better stewardship of the drugs that we have. We must protect the drugs that have been developed already from overuse and misuse. We must recognise what a precious global resource these drugs are and treat them accordingly.
2) We need more, better targeted antimicrobials and alternative strategies. Scientists are continuously looking to come up with new drugs, but they need to be in areas where they are required. They are also working on clever new ways to keep micro-organisms at bay.
For example, scientists are investigating the use of viruses (called bacteriophages) that exist naturally to kill bacteria. So rather than use chemicals that the bugs become resistant to over time, this technology uses a natural process, reducing the likelihood that AMR will develop.
3) New financial models and incentives. The AMR action fund was set up to fund clinical trials of drugs in critical areas and provide a push incentive for companies to invest in R&D. But even when drugs successfully make it through the R&D and clinical approval process, the problem of not making enough money from those drugs remains. So if the market fails, maybe it is time for government to step in with pull incentives. Some are advocating a utilities type model, in which antimicrobials are treated as a national resource to be managed in the same way as water or electricity. Some countries are working on using different models of reimbursement rather than the traditional supply/demand market model.
4) New diagnostics. In order to reduce prescription rates of antibiotics and target drugs in the most effective way to where and when they are needed, fast, more accurate and affordable tools (diagnostics) are required.
Collaboration is key
If the world is to solve the AMR problem, it will have to work together. As the corona virus pandemic has shown so starkly, micro-organisms do not recognise borders or nationalities. AMR is a complex, multi-faceted and global problem. It will require economists, regulators, scientists, businesses, health practitioners and others to work in partnership. What happens in farms in one corner of the world will affect those in other parts of the world. Misuse in one country leads to AMR across the world, affecting the whole of the human family. As the saying goes ‘nobody is safe until everybody is safe’!
Innovate UK welcomes the Global AMR Community: The AMR innovation mission to the UK 2021
Next week, 10, 11 and 12 May (pm), Innovate UK, in partnership with AMR Insights and Innovate UK EDGE, is proud to be hosting more than 250 delegates from over 40 countries to take one further step towards a world free from AntiMicrobial Resistance. We have a fantastic range of speakers lined up across the three afternoons. We will focus on three areas, one per day:
10 May: Diagnostics
11 May: Antimicrobials and Antimicrobial Strategies
12 May: Preventives and Stewardship
We want to help to connect the best of global AMR science and innovation with the UK eco-system, providing an inspiring platform for conversations to take place. We will provide the tools for those conversations to continue after the event so that strong partnerships can form, that can go on to make a real difference. We hope, expect and are preparing to welcome a delegation of AMR to also visit the UK when the conditions are right. We will listen to what our delegates will be telling us next week, we want to know what they are interested in and where they think we should be focussing our efforts.
If you have signed up already, we are very grateful and hope you will have a fantastic event. If you haven’t, we invite you to find out more and if you want to come and play, welcome you to the event - AMR Innovation Mission to the UK 10 - 12 May 2021
Call to arms
Whether you are a parent, a farmer, a food producer, a banker, an economist, government policy maker, or a scientist, a member of the public, we call on you to make a difference, we all have a role to play.
Together we can slowly start to turn the corner and build on all the global efforts already going on. If the past year has shown us anything, it is how the human race can rise to the challenge and solve the toughest problems. Why would AMR be any different?
Peter Dirken, Phil Packer and Maarten van Dongen