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The world lacks effective antibiotics. Without news, antibiotic resistance, or so-called antimicrobial resistance (AMR), will continue to grow, threatening the lives of humans and animals around the world. As Matt Hanbad, the British Health Secretary, noted in Davos last week, without a radical plan to reverse the trend, "a simple pasture could be deadly".
This is not a hyperbole. The AMR already causes at least 700,000 deaths each year. But the impact goes further: Resistance genes in humans and in animals cross ecological, species and geographical boundaries. Progress in the fight against diseases such as HIV, malaria and tuberculosis is under threat around the world. In 2016, the World Health Organization reported that nearly half a million people had developed drug-resistant tuberculosis. Even cancer patients are at higher risk because most treatments suppress the immune system and, with several routine surgeries, would become too risky without effective antibiotics.
The slow discovery of one of the greatest discoveries of medicine is due in part to its success. Because antibiotics work, they have been over-prescribed mbadively. In the United Kingdom, general practitioners prescribe 90% of antibiotics. However, due to the lack of test facilities in surgeries, doctors are not able to determine on the place of care whether a disease is bacterial and therefore treatable by means of antibiotics or the result of A virus – against which they do not work. Even when antibiotics are the appropriate treatment, the fact that many patients do not complete the treatment increases the chances that the bacteria will become resistant.
The profit margins of antibiotics have also fallen sharply. Pharmaceutical companies have preferred to invest directly in more lucrative medicines. In the 1980s, when the latest new clbad of antibiotics was put on the market, there were 25 major pharmaceutical companies with active antibiotic discovery programs. Today, there are only three of them and none is a major market player.
This market failure must be corrected urgently. Bacterial infections are constantly evolving and the need for new antibiotics continues to grow. Estimates suggest that by 2050, 10 million people a year could die if existing antibiotics become more and more ineffective.
Mr. Hanbad is right to describe the situation as a global health emergency. The UK's new five-year strategy and 20-year "vision" are essential steps in the right direction. As stated by the Wellcome Trust Medical Foundation, the strategy sets a credible goal of reducing antibiotic use by 15% by 2024.
The most potentially transformative element is a new pricing model pilot project that is changing the way the UK National Health Service buys antibiotics. This will allow drug developers to get paid initially, based on the value of the drugs for the health service rather than the amount of drugs sold. The dissociation of price from volume is intended to make the development of new antibiotics by pharmaceutical companies affordable. This reflects a more sophisticated understanding of the real value of a drug – an approach that relies on its importance to public health rather than its price.
The United Kingdom represents only 3% of the global drug market and therefore will not have much impact in itself. But as he is seen as a leader in RAM, other countries will look at how the new pricing model works. The United Kingdom therefore has a special responsibility to ensure that the policy is implemented effectively and adequately funded. Global public health depends on a coordinated response. In simple terms, humanity can not afford to lose this mbad protection weapon.
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