We are currently facing one of the biggest health care threats of our lifetimes. Why is antimicrobial resistance (AMR) so important now?
Right now, COVID-19 is testing the limits of our health care system. Many deaths attributed to pandemics like COVID-19 are due to secondary infections caused by antibiotic-resistant “superbugs.” Antibiotics and antifungals underpin modern medicine, and growing antimicrobial resistance jeopardizes people’s health and the entire health system. While treatment advances for serious chronic diseases accelerate, we are losing ground in our ability to fight bacteria and other life-threatening infections. Every time people take antibiotics, some bacteria may survive, multiply, and evolve to become resistant to existing treatments. This means that new resistance to our current treatments continuously emerge, rendering many existing drugs ineffective and shrinking our treatment arsenal.
Without effective treatments for drug-resistant infections, patients lose not just protections against infectious diseases such as pneumonia, but also other advances of modern medicine that rely on the ability to effectively treat and prevent hospital and community-acquired infections. This includes organ transplantation, cancer chemotherapy, major surgery, and care of preterm infants and immunocompromised patients, among others. Even routine procedures and surgeries involve greater risk from the rise in antibiotimicrobial-resistant infections.
Re-establishing a robust pipeline to build up our arsenal of antibimicrobial treatments is critical given that hard-to-treat bacteria and fungi continue to emerge. We must act, and act now.
How are we so unprepared? And what comes next?
The world is currently witnessing what happens when we don’t have treatments to address highly contagious, infectious diseases. Because of the lack of sufficient financial incentives in the current system, the necessary investments are not being made in the research and development of new antimicrobial treatments. We must act now to overcome obstacles that have deterred this investment to date.
Treatments for resistant infections are extremely difficult to develop, and opportunities to recoup development costs and to make a return on investment are limited. Currently, it takes 23 years for a company to see profit on a new antibiotic. In addition, current reimbursement policies often disincentivize use of the most appropriate treatments in hospital settings. And stewardship programs that are designed to reduce the development of new resistance can further limit the use of newly developed medicines.
Putting policies into place to ensure that academic and industry scientists are incentivized to cooperate and create a sustained and robust pipeline of new antibacterials medicines and novel therapies that save lives is critical to our economy. Finding opportunities that educate patients, engage investors, and empower innovators is more important than ever in the fight against infectious disease.
Who can have the biggest impact on addressing AMR issues?
We all can play a role in addressing and slowing the development of AMR. At an individual level, it starts with hygiene and thorough adherence to treatment when antibiotics, antifungals, or antivirals are prescribed. For health care providers and facilities, public awareness, sanitation, early point-of-care diagnostics, clinical guidelines and good stewardship are important factors. For policymakers, passing legislation that can create the environment to encourage investment in new treatment options is essential. Our government needs to to help incentivize innovation by:
Supporting investment in early stage research and development of new medicines,
Advancing efficient regulatory development and review pathways,
Establishing payment and reimbursement policies that address barriers to appropriate use and stabilize the market,
Developing solutions to stimulate investment by creating an attractive market.