Growing numbers of bacterial and viral infections are resistant to antimicrobial drugs, but no new classes of antibiotics have come on the market for more than 25 years.
Around 25,000 people already die each year from infections resistant to antibiotic drugs in Europe alone and the lack of new drugs which are capable of fighting bacteria has been described by the World Health Organization as one of the most significant global risks facing modern medicine.
The Prime Minister wants Britain to lead the way, using its international leadership and world-class pharmaceutical sector - which employs thousands of highly-skilled experts and is a key part of the country’s economy – to battle against antimicrobial resistant infections and bring new drugs to the world market.
Mr Cameron has commissioned a wide reaching independent review, led by the internationally renowned economist Jim O’Neill and co-funded and hosted by the world’s second largest medical research foundation, the Wellcome Trust, to explore the economic issues surrounding antimicrobial resistance.
The review will set out a plan for encouraging and accelerating the discovery and development of new generations of antibiotics, and will examine:
The development, use and regulatory environment of antimicrobials, especially antibiotics, and explore how to make investment in new antibiotics more attractive to pharmaceutical companies and other funding bodies.
The balance between effective and sustainable incentives for investment, and the need to conserve antimicrobial drugs so they remain effective for as long as possible.
How governments and other funders can stimulate investment in new antimicrobials and timeframes and mechanisms for implementation.
Increasing international cooperation and support for action by the international community, including much closer working with low and middle income countries on this issue.
Jim O’Neill will work independently of government, and will have full freedom to approach the issues and the evidence as he sees fit. He will work with international experts covering all aspects of the AMR pipeline and associated economic issues to identify a range of proposals that can form the basis of a new, strengthened global effort.
The full scale of the economic burden of drug resistant infections – and the cost of a failure to take concerted action to address it – is not yet fully understood.
The announcement of the review comes a week after antimicrobial resistance was chosen by the public as the winner of the £10m Longitude Prize, with a focus on creating a cheap, accurate and easy-to-use test for bacterial infections that will allow doctors and nurses to better target antibiotics and prevent over-use.
The Prime Minister, David Cameron, said:
Resistance to antibiotics is now a very real and worrying threat, as bacteria mutate to become immune to their effects.
With some 25,000 people a year already dying from infections resistant to antibiotic drugs in Europe alone, this is not some distant threat but something happening right now.
If we fail to act, we are looking at an almost unthinkable scenario where antibiotics no longer work and we are cast back into the dark ages of medicine where treatable infections and injuries will kill once again.
That simply cannot be allowed to happened and I want to see a stronger, more coherent global response, with nations, business and the world of science working together to up our game in the field of antibiotics.
Following discussions at the G7 last month, I have asked the economist Jim O’Neill to work with a panel of experts and report back to me and other world leaders on how we can accelerate the discovery and development of a new generation of antibiotics.
Professor Dame Sally Davies, Chief Medical Officer for England, said:
The soaring number of antibiotic-resistant infections poses such a great threat to society that in 20 years’ time we could be taken back to a 19th century environment where everyday infections kill us as a result of routine operations.
We have reached a critical point and must act now on a global scale to slow down antimicrobial resistance. In Europe, 25,000 people a year already die from infections which are resistant to our drugs of last resort. The biotech and pharmaceutical industry will be central to resolving this crisis which will impact on all areas of modern medicine.
We cannot tackle the problem on our own and urgently need coordinated international action, which is why I am delighted to see the Prime Minister taking a global lead by commissioning this review.
Dr Jeremy Farrar, Director of the Wellcome Trust said:
Drug-resistant bacteria, viruses and parasites are driving a global health crisis. It threatens not only our ability to treat deadly infections, but almost every aspect of modern medicine: from cancer treatment to Caesarean sections, therapies that save thousands of lives every day rely on antibiotics that could soon be lost. We are failing to contain the rise of resistance, and failing to develop new drugs to replace those that no longer work. We are heading for a post-antibiotic age.
This is not just a scientific and medical challenge, but an economic and social one too. I am thus delighted that an economist of the stature of Jim O’Neill has agreed to investigate these issues, with an eye on the incentives, regulatory systems and behavioural changes that will be required to resolve them. The Wellcome Trust is proud to fund and host Jim O’Neill and his team as they conduct this vital work.
Dr Jim O’Neill said:
I am delighted and honoured to be asked by the Prime Minister to undertake this review. The emergence of drug-resistant infections and the lack of a sustainable pipeline of antimicrobial drugs are mounting threats to society, and it’s clear that international action is needed now if we are to prevent lives being lost unnecessarily. As someone who has been immersed in how the world may develop, finding ways to stop this problem is a very exciting challenge.
Dr Margaret Chan, Director General of the World Health Organization (WHO) said:
The UK is demonstrating strong leadership in raising awareness about the global threat posed by antimicrobial resistance. Forming this Review is a crucial step towards ensuring that the world has effective medicines to combat infectious diseases. WHO will work closely with the Review and other key partners on this important initiative.
The review will present its initial findings during 2015 with a final report and recommendations to then follow during 2016. This process will run alongside – and engage closely with – the WHO’s development of a Global Action Plan on AMR.
The Resolution on Antimicrobial Resistance passed at last month’s World Health Assembly in Geneva recognised the pressing need for the global community to act immediately in the fight to combat increasing resistance. There is also an increasing drug resistance problem among infections caused by viruses and parasites.
Jim O’Neill is an internationally respected and published economist, and until 2013 was Chairman of Goldman Sachs Asset Management, having previously been the organisation’s Head of Economic Research. He is particularly well known for his work in relation to developing and middle-income economies having coined the BRIC and MINT acronyms – meaning that he is especially well-placed to understand the broad range of international interests at play with this topic. He will begin work on the review following the completion in the autumn of the work of the City Growth Commission, of which he is currently chair.
The Wellcome Trust is a global charitable foundation that spends more than £700 million a year on advancing human and animal health. It is the second highest-spending charitable foundation in the world, after the Bill & Melinda Gates Foundation, investing principally in biomedical science, the medical humanities and public engagement.
The Trust is providing funding for the work of the O’Neill review, and hosting the team at its Trust’s London headquarters.
Limited staffing costs for the review will be met by the UK Government, with new research commissioned as part of the review process funded by the National Institute for Health Research (NIHR). Full terms of reference for the review will be published in due course, once finalised by the review’s chair.
The review will operate independently of the UK Government and draw support from an international expert advisory panel. Both G7 and non-G7 members will be engaged in the process, as will the academic community, industry, and multilateral organisations such as the WHO, Commonwealth and European Commission.