If left unchecked, a superbug can cause a disaster worse than Covid

You may have thought that top policymakers may have learned some great lessons from the stunning Covid-19 shock of the last two years, but they often seem not to.

Yes, policy makers have learned many lessons from several pharmaceutical companies in space about the role of vaccines in responding to future viral infections and high hopes that existing vaccines can be adapted relatively easily and quickly. What about the so-called silent pandemic of antimicrobial resistance (AMR)?

The fight against AMR still seems to remain a worrying side show because it is not on the television channel every night due to the growing number of people it kills.

As we have witnessed when infections that cannot be treated go wild, the effect is great. Covid-19 continues to kill a tragically large number of people, and the impact on the world economy is huge – in 2020 it will exceed $ 10 trillion. However, five million people die each year from drug-resistant infections.

If we don’t do something dramatic and address antimicrobial resistance soon, the effect will be much worse than Covid. Our 2014 review of the AMR in the UK – a report aimed at understanding and proposing solutions to the problem of drug-resistant infections from an economic and social perspective – estimated that the global economy could lose $ 100 trillion by 2050 if it did not nothing was done.

That’s a hundred times more than it would cost to prevent the problem. Now that we’ve seen up close what happens when the threat to public health turns into a state of emergency around the world, why don’t policymakers take antimicrobial resistance seriously?

Looking at it through Covid optics, it’s worth asking, “how would the world evaluate a treatment in April 2020 that could completely wipe out Covid-19?” Only in economic terms would the value be enormous.

However, the amount of money you would pay in 2018 for such a product is probably very low. In fact, it is only now that we are truly aware of the value of such treatment, as it has not been. If it had existed at the time, Covid-19 might not have come further than titles like “Treatment 2018 Cures Outbreak of Viral ‘Pneumonia’ in Wuhan.”

Antibiotic resistance is similar. If there is an outbreak of a new strain of bacteria that we already have treatment for, the doctor may switch to another medicine when the medicine is canceled, which limits the spread of resistant bacteria.

This treatment plan prevents widespread resistance and its impact – when it works – is mostly invisible. But one day there won’t be the next drug we can switch to. So now we need a way to fund future antibiotics – to be ready when there is no next drug.

Global cooperation

The UK government is taking some steps to address this threat. The government is currently implementing a pilot plan to promote new treatments. According to their plan, instead of paying pharmaceutical companies for drugs based on current use (which could be low), they pay the drug manufacturer for the potential future value of the drug.

This means that manufacturers of pilot antibiotics in the UK currently receive £ 100 million a decade to produce the following medicines, regardless of how many doses are used. This model provides income to the innovator and also protects the UK government from high costs if rebellion rises into the sky.

This is a very welcome development, although only two antibiotics are currently being developed under this system. To ensure that we are ready to tackle future antimicrobial resistance, this plan needs to be extended to all new antimicrobials.

But even the rest of the world needs to pull their weight. In the U.S., lawmakers on both sides of political work have introduced the PASTEUR Act, which would provide between $ 750 million and $ 3 billion for a new drug developed over the next decade that meets pre-determined criteria. This important political solution came before the pandemic, but the upcoming midterm elections mean a shortened legislative calendar for 2022 and only a short period for action.

Most of the rest of the world is lagging behind. While most countries have national action plans to address AMR, less than one in five has identified funding sources for them. For example, the European Union and the vast majority of its members have not yet provided detailed plans on how to purchase these essential medicines.

Low- and middle-income countries have lagged even further behind. Many people do not have access to the latest medicines at all, so funding new innovations is a lower priority, as new medicines that you cannot buy have no value. There has also been less research on how to pay for these new drugs in these parts of the world.

However, it is also important to set up systems that encourage research into the medicines that these countries need, reduce incentives for drug oversupply and provide access to all those who need it. To this end, the Center for Global Development is setting up a working group entitled The Great Contract for the Procurement of Antimicrobials – which seeks to find effective political solutions to this problem that balance the different needs of countries.

In the last three years, we have seen the destruction that can happen when a global health threat catches us unexpectedly. However, unlike Covid, we already know the enormous devastation that antimicrobial resistance could cause, and we know what tools are needed to address it. Gone are the days when global policy makers turned their attention to this important issue and put in place common sense plans to promote pharmaceutical innovation that prevent us from ever coming up with the latest drug. The lives of people all over the world depend on it.

• Anthony McDonnell is a senior political analyst at the Center for Global Development and a former head of economic research for the AMR Review. Jim O’Neill is a former member of the Pan-European Commission for Health and Sustainable Development, former chairman of the AMR Review, former chief economist at Goldman Sachs and commercial secretary of the UK Treasury.

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