There is a need to find practical long-term solutions to antimicrobial resistance – and they need to be implemented aggressively, says Ana Nicholls, chief healthcare analyst, The Economist Intelligence Unit

After a decade or more of warnings over potential pandemics such as bird flu and Ebola, it is easy to ignore alarming headlines. Yet there is one global health threat that certainly should not be ignored: the upward trend in drug-resistant infections, and the failure to discover new antibiotics to tackle them. Some scientists warn that this poses a greater threat to human health than AIDS or even climate change, leading to a rise in drug-resistant versions of diseases such as tuberculosis and malaria, and threatening to make routine operations lethal.

The issue is hardly an unknown one: Alexander Fleming, discoverer of penicillin, warned about it in 1945. But in recent years, the warnings have become starker. Two years ago, David Cameron, the UK prime minister, decided to champion the cause, in part by establishing the Review on Antimicrobial Resistance (RAR). The US president, Barack Obama, and the German chancellor, Angela Merkel, have also spoken about the growing threat and the need for coordinated global action.

At The Economist’s Pharma Summit on 26 February 2015 in London, speakers from government and industry will debate the issue. It will also be raised at this year’s G7 summit, where the RAR will use some alarming forecasts to galvanise the world into action. By 2050, according to a RAR report published last year, drug-resistant infections could cause 10 million deaths a year and lead to a US$100 trillion a year dent in the global economy. Moreover, Jim O’Neill, the economist heading up the Review, and keynote speaker at The Economist Events’ Pharma Summit on 26 February, says those figures may well be an underestimate.

The challenge, amid all these warnings, is to find practical long-term solutions to antimicrobial resistance – and they need to be implemented far more aggressively than they have been to date. The biggest issue is how to prevent overuse of antibiotics by doctors, patients, farmers and fisheries: a global task that has proved harder than many imagined.

Another problem is no new class of antibiotics has been developed for more than 25 years. Given new antibiotics are used only as a last resort, and often for a few short weeks, the commercial payback has been too low to justify enough R&D spending. How can public bodies overcome that market failure? And how can new technologies, from genetics and genomics to information technology, improve the diagnosis, reporting and treatment of bacterial infections?

Changes are coming. In 2012, the EU set up a programme to encourage public-private funding of research, while the USA approved its ground-breaking GAIN legislation to boost research. The results of these programmes are just starting to feed through, notably with the US Food and Drug Administration’s approval of two new antibiotics in 2014. But things are still not moving fast enough. There is an urgent need to update R&D regulations and funding and, above all, to take coordinated global action to stop doctors, patients and farmers from using antibiotics unnecessarily. 

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