The epidemic of infections caused by bacteria and other microorganisms that don’t respond to treatment – known as antimicrobial-resistant (AMR) infections – is threatening the world’s health and economy.

A review commissioned by the UK Prime Minister, David Cameron, estimates that by 2050 AMR will cause 10 million more deaths a year worldwide – more than those caused by cancer today – and will cost the global economy up to $100 trillion over the next 35 years.

Antimicrobial resistance is a natural phenomenon. Bacteria, for example, can mutate to be resistant to certain antibiotics, making them less effective. But the chances of this occurring increase dramatically if antibiotics are used unnecessarily or incorrectly.

Industry’s role

A pipeline of new antimicrobial drugs and a reliable supply chain are crucial, says Dr Virginia Acha, executive director of research, medicine and innovation at the Assocation of the British Pharmaceutical Industry’ (ABPI).

“There are 34 agents in development, including 15 for gram-negative bacteria, which are the more resistant to current antibiotics. The problem is, bacteria soon become resistant to whatever new drug you challenge them with, so you want to use novel treatments as prudently as possible, and hold them in reserve for when really needed.”

Delinking revenues from sales

But, as Dr Acha notes, the above means that pharmaceutical firms cannot recuperate investment in the usual way. So, it’s crucial to delink revenues from use through insurance-based models, for example, or premium-pricing schemes that reimburse only drugs used when and as needed. We need to think of both “push” and “pull” policy measures; “push” to advance the science and “pull” to ensure a sustainable pipeline and delivery of antibiotics, when and where they are needed. This way there will be an incentive structure that promotes both innovation and proper drug use.

Patient awareness

“In addition, better access to diagnostics can help doctors make right decisions when treating infections, and explain these to their patients,” says Dr Acha. “It’s often patients who ask for antibiotics. We need to help them understand why antibiotics are not always the right choice for treatment. And this is something that the government can help with, together with anybody else who can help get the message across.”

Collaborative effort

Dr Acha adds: “We want to ensure that people use antibiotics properly, so that these retain their potency. And for this we need collaborations between industry, government, healthcare professionals and the public. There is real potential for us to deal with antimicrobial resistance in increasingly innovative ways, which will help solve the problem.”

Looking ahead

Despite the challenges, Dr Acha is positive about the future. She says that, as scientists understand more about the biology of drug resistance and how our immune system works, we will see great potential for containing and, hopefully, eliminating the global threat of drug resistance. But, for this to happen, it’s key that the incentives are there for the industry, scientists and policy makers to continue the vital work they are doing in this area.