The COVID-19 pandemic has certainly stolen the limelight from other key health threats, but it is important to remember that they, like the ‘slow burning’ yet pertinent public health challenge of AMR, are still with us, too. What COVID-19 did demonstrate is that interestingly, in an emergency situation, while the initial reaction is more of a ‘fight and flight response’, upon further reflection we all acknowledge that in the face of common threats, it’s ultimately down to a joint effort to respond adequately. Will a call for more Europe in health in the aftermath of the COVID-19 health crisis therefore also mean more European collaboration and action on AMR?
Cristian-Silviu Bu?oi, Member of the European Parliament, stressed that AMR will be among the priorities of the EU4Health Programme and that AMR-related research and development will continue to receive funding under the Horizon Europe Framework. So, are money and political support all we need?
No, because just like response to a deadly outbreak requires a multi-faceted approach, so does AMR – it’s not enough to speak of R&D investment for new antimicrobials, but we need an all-encompassing One Health solution package that also looks at prevention of infections in healthcare settings and stewardship said John Ryan, Director at the European Commission’s Directorate-General for Health.
At the same time, there is a worrying lack of availability and access to new antibiotics, some of which are critical to treat resistance in patients, said Christine Ardal from the Norwegian Institute of Public Health. Very often the issue is not just the development itself, but also insufficient incentives due to low sales and low prices, and the struggle of getting new antibiotics to the market, a process which is not homogenous across Europe. Small and medium-sized enterprises are particularly affected, but Jeremy Knox, Wellcome Trust, reminded us that initiatives such as the recent AMR Action Fund are a positive step forward in this regard.
A dry pipeline for novel antibiotics is only one side of the problem. The other is sustaining access to already existing effective antibiotics. Some countries have undertaken initiatives to guarantee both access to innovative antibiotics to their citizens and annual revenues for manufacturers. However, as Christine Ardal stressed, not all states have the financial capacities to absorb these costs, leading once more to access disparities.
Can we apply the lessons learned from COVID to AMR and emulate good examples such as joint EU procurement for vaccines? Seems like we can… Most active pharmaceutical ingredients currently come from third countries. Pharmaceutical industry sustainability in Europe, including financing innovative medicines such as novel antibiotics, is therefore expected to be addressed in the upcoming EU Pharmaceutical Strategy. But will this really make a difference? Expert opinion in the session varied, with some believing a new European BARDA could be a game changer for AMR and others, such as MSD representative Jenelle Krishnamoorthy, arguing that while such an institution can help on push incentives, the next step needs to be a focus on pull incentives to get new drugs across the pathway and into the market.
AMR has received high-level political attention from world leaders – but has this political momentum resulted in concrete action on the ground? During the debate, one important point was made: the downside of getting AMR up high on the political agenda means that it is easier for patients to be pushed aside. Patient groups need to be mobilised to recognise how important an issue AMR is and it needs to be ensured they sit at the table alongside other key interlocutors to discuss ways forward.