Antibacterial Resistance takes Center Stage in Geneva


22 July 2013

Antibiotic resistance took center stage in Geneva, both at the Trilateral Symposium on Medical Innovation, hosted by the World Health Organization, the World Trade Organization and the World Intellectual Property Organization, on July 5th and in the findings of the 2013 update of Priority Medicines for Europe and the World launched on July 9thMany experts addressed antibiotic resistance as an urgent global health threat, including WHO Director General Margaret Chan.

In her opening remarks to the WIPO-WTO-WHO technical symposium on “Medical Innovation & Changing Business Models,” WHO Director-General Margaret Chan noted the urgent challenge of a post-antibiotic era and the dire consequences of running out of effective, first-line antibiotics. ReAct’s Strategic Policy Unit Director, Dr. Anthony So from Duke University, gave focus to these policy concerns by discussing the scientific and financial bottlenecks to innovation through the lens of antibiotic resistance (see symposium agenda and presentation here)

Discovering novel classes of antibiotics has proven to be a significant scientific challenge. Curing an infection in a few days- as opposed to treating a disease, like high blood pressure, for life- also results in lower returns for companies investing in antibiotic R&D compared to other therapeutic classes. The shortage of novel antibiotics is particularly worrisome given the growing burden of resistance and punctuates the need for looking at new business models. He suggested the need to innovate our approach to innovation, applying tiering and pooling as well as push and pull financing mechanisms in concert.

He called attention to the importance of piloting approaches that delink R&D investment from both prices and–in the case of antibiotics–quantity as well. However, with push financing like the EU’s Innovative Medicines Initiative or U.S. BARDA (the Biodefense Advanced Research and Development Authority) program or pull mechanisms like prizes for diagnostics, there also must come commensurate returns on these public sector investments, especially in ensuring life-saving antibiotics are affordable to those in need.

Illustrating the importance of collaborative R&D, he showed how the fledgling, but promising India Council on Scientific and Industrial Research’s Open Source Drug Discovery Initiative had already made significant strides in successfully sharing resources, risks and rewards to improve upstream innovation with an eye on downstream access. This 3Rs framework was discussed in an article in the BMJ.

In contributing to this panel, Richard Laing–lead author behind the WHO reportPriority Medicines for Europe and the World launched on July 9th–described the importance of antibiotic resistance in the 2013 update, that recalls the 2004 report’s conclusion that “we are facing the possibility of a future without effective antibiotics.”

In the report’s chapter on priority diseases and their reasons for inclusion, antibacterial drug resistance leads off as the first of a series of conditions. These conditions are “associated with a pharmaceutical gap in that many pharmaceutical treatments for them are already ineffective and many others will soon become ineffective. Both [antibacterial resistance and pandemic influenza] pose enormous threats to global public health which will require major multi-sectoral responses.”

In closing, Professor So reminded policymakers of how penicillin was brought to market, with concerted public-private partnership, as a generic drug during the second World War. And he concluded that: “Indeed the need today for a global R&D framework, beginning with efforts to address the public health challenge of antibiotic resistance, may give our children a future free from the fear of untreatable infections.”