To incentivize the discovery of new antibiotics and encourage
researchers around the world to undertake new research requires
significantly increased global funding from a combination of
both public and private sources. To ensure that this funding is
focused effectively and invested efficiently, the Review on Antimicrobial Resistance has called for the establishment of a Global
Innovation Fund to coordinate this.
This body would support early-stage and non-commercial
research, helping to form consortia made up of universities,
small pharmaceutical companies, CROs, and partner research
organizations to take on programs to develop new antibiotics.
These partnerships benefit from shared resources and knowledge,
helping to make more efficient use of expertise and funding to
bring about advances in our understanding of drug targets and
new drug molecules more rapidly.
Better disease prevention, diagnosis and surveillance
Another effective way of slowing down the spread of resistant
bacteria is through the prevention of infection in the first place.
To do this, there must be global concerted efforts to improve
hygiene. Simple measures, such as handwashing, are particularly
effective at reducing the spread of infections in hospital settings.
In the developing world, greater access to clean water and sanitation will play a critical role in addressing this problem.
An additional way to reduce the number of infections and lower
the demand for therapeutic treatments is through vaccination.
However, in low and middle income countries, numerous bottlenecks around healthcare infrastructure and cost limit the extent to
which vaccines can be rolled out. Organizations such as Gavi and
the Vaccine Alliance, are tackling these challenges by funding vaccination programs in countries that would otherwise be unable to
do so. By pooling the demand for new vaccines for these countries
and financing their implementation, the organization helps to attract
new vaccine manufacturers into the market and bring costs down.
A further challenge to overcome relates to disease diagnosis.
In previous decades, clinicians have arguably been too quick to
prescribe antibiotics when the underlying cause of the disease
is unclear. This situation often arises as prescribing antibiotics
without fully identifying the disease is faster and usually less
expensive than running lengthy diagnostic tests. Therefore, more
affordable, rapid and reliable diagnostic technologies will be essential to ensure that infections are being treated using the right
type of antibiotics, and only in the case of bacterial infections.
Of course, it’s important that we continue to monitor the use
and effectiveness of antibiotics, as well as mechanisms for resistance at both national and international levels. Such information
is necessary to form health policies, guide responses to health
emergencies and identify global, long-term trends.
The issues that have led to the current crisis in antibiotic resistance are both global and multifaceted, and will require international collaboration if they are to be overcome. While changes
to the current economic model for antibiotic development are
necessary to ensure we have a well-stocked supply of new and
effective drugs, it is also essential that we reduce their demand
through better stewardship. Only through learning from our mistakes will we ensure that these precious resources are available
and remain effective in the future.
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