The WHO declared Antimicrobial Resistance one of the top 10 global health threats to humanity, requiring “urgent multisectoral action”. Multidrug-resistant bacterial infections cause 33,000 deaths in the EU annually. The CDC suggested in 2013 that more than 2 million people each year are affected by antibiotic-resistant infections. At least 23,000 die as a result. AMR provokes widespread death and disability, which in turn have that ever-influential effect: economic consequences.
The WHO states that “prolonged illness results in longer hospital stays, the need for more expensive medicines”, as well as financial challenges for patients. The EU faces an annual estimated cost of €1.5 billion due to healthcare expenditures and productivity losses. In the US, the 2013 estimated annual cost was as high as $55 billion, with $20 billion attributed to direct healthcare costs. The remaining $35 billion resulted from society costs for lost productivity. Meanwhile in South Africa, roughly 32% of the 2011 TB budget was spent on drug-resistant TB, despite the fact that it represented only 2% of TB cases.
Evidently AMR is a financial as well as a social burden. How is the industry responding to this challenge?
Shelley McLendon of ICON suggests that the incentive to develop new antibiotics is low because of waning efficacy. Alongside this, the upfront cost of drug development is $1.5 billion.* In order to contain and monitor AMR outbreaks, McLendon emphasises the importance of “affordable, accurate and rapid diagnostics”. These will inform patient care and may prevent overuse or misuse of antimicrobials. She suggests PCR diagnostics, which rise to the challenges of pathogen identification, but recognises that they require specific technologies and conditions limited to laboratory settings.
Further technologies such as NGS and AI have potential in these diagnostic developments. McLendon cites Imflammatix as an example of a company combining NGS and AI to this effect. She believes we can develop novel diagnostics alongside efforts to combat Covid-19, with increased investment.
McLendon’s key takeaway?
Microbial evolution “will not wait while we decide whether to treat the global problem of AMR with the seriousness it deserves”.
Professor Kenneth Keiler of Penn State University predicts that an increase in resistance might encourage policymakers and pharmaceutical companies to respond with research into new antibiotics. However, he doesn’t see this happening until “we reach a scary point”. While we continue to discuss the benefits of research, lives are lost and affected. As McLendon identifies – the global problem is serious, and ongoing.
*To join a day of AMR discussion at the World Vaccine Congress Europe in October head to this page to get your tickets.