A powerful global organisation similar to the one on climate change needs to be established in order to genuinely get to grips with the problem of growing resistance to antibiotics.
That is the basis of a comment piece written in the journal Nature by Mark Woolhouse of the University of Edinburgh, and Jeremy Farrar, director of the Wellcome Trust. The argue that what is required is "committed and coordinated action on the root causes of resistance: the misuse of antimicrobials, the paucity of development of new drugs and the lack of alternatives".
They say guidelines must be implemented to improve the use of existing drugs, claiming that "the scientific and business worlds need incentives and a better regulatory environment to develop new drugs and approaches". Furthermore, "those working in both the animal and human sectors need education and incentives to help them to change their ways".
To achieve this, Prof Woolhouse and Dr Farrar call for the creation of an organisation similar to the Intergovernmental Panel on Climate Change (IPCC) "to marshal evidence and catalyse policy across governments and stakeholders". They want to see "a powerful panel to marshal the data to inform and encourage implementation of policies that will forestall the loss of effective drugs to resistance, and to promote and facilitate the development of alternatives".
Must not 'simply restate problem'
They go on to say that an intergovernmental panel on antimicrobial resistance (IPAMR) "must have the same firm foundation on the best available science" as that of climate change and have "potentially an even stronger mandate for action". The IPAMR "needs to avoid simply restating the problem [and] move rapidly to an agenda that includes identifying key knowledge gaps and how to fill them". It could, for example, "support studies to investigate dosing regimes that stall resistance, coordinate incentives for developing new types of antimicrobial and set targets for prescriptions and animal use".
The experts state that the IPAMR "must be trusted and free of vested interests" and involve "a broad range of experts, encompassing clinical and veterinary medicine, epidemiology, microbiology, pharmacology, health economics, international law and social science". It will also need technical, financial, industrial and political support from governments and agencies, "as well as from representatives of producers and consumers of antimicrobial drugs."
Dr Farrar said that "we have needed to take action against the development of antimicrobial resistance for more than 20 years. Despite repeated warnings, the international response has been feeble. The World Health Organisation has missed opportunities to provide leadership, and very little progress has been made". Prof Woolhouse added that "we need independent, international leadership on this issue before the massive health gains that have been made since Alexander Fleming’s discovery of penicillin are lost forever.”
Later today (Friday), the WHO will vote at its annual meeting in Geneva on a resolution to develop its own global action plan to fight antimicrobial resistance.