The intervention from Chief Medical Officer for England Dame Sally Davies echoed that of British Prime Minister David Cameron, who said antibiotic-resistant superbugs threatened to send medicine “back into the dark ages.”
In a series of interviews, Davies said she welcomed the prime minister’s initiative in asking Jim O’Neill, a former Goldman Sachs chief economist, to lead a group of international experts to consider how drug companies can be encouraged to make new antibiotics.
“I am delighted to see the prime minister taking a global lead by commissioning this review to help new antibiotics to be developed and brought to patients effectively,” she said.
Davies told BBC Radio 4’s current affairs Today program that antibiotic-resistant infections were a grave problem that was getting worse. In England, she said, 5,000 people die from antibiotic-resistant infections each year.
“Deaths are increasing and there is an empty pipeline of drugs,” she said.
Davies went on to warn that surgery for hip transplants and caesareans, and treatment for diseases such as cancer, would be hard to carry out if there were no means to kill off random infections in patients.
“Modern medicine would quickly go out of the window,” she said.
Louise Leong of the Association of the British Pharmaceutical Industry said antibiotics were a victim of their own success through overuse and low prices, adding there was a need for a new economic model bringing together the private and public sectors.
Leong told the Today program that this was already happening through the Innovative Medicines Initiative, Europe’s largest public-private sector medical collaboration to tackle big health challenges, including antibiotic resistance.
The pharmaceutical industry has little incentive to invest in research for drugs that are not taken every day and so do not reap large profits, but Davies pointed out that unless the companies deal with antibiotic resistance, their drugs for cancer and other illnesses will not sell if antibiotics no longer work.
The pharmaceutical industry has produced three generations of antibiotics in the past 60 years. The first included natural penicillins. However, this group became ineffective as bacteria evolved enzymes that broke the drugs apart. The second were synthetic penicillins, modified in the lab to resist these enzymes, but bugs gained resistance to these too. The third generation, carbapenems, have been further modified. In 2003, the first microbes arrived in Britain that are immune to even these.
Cameron, who this month called for immediate action to accelerate the development of drugs for dementia, is said to have raised the problem of antibiotic-resistant superbugs during last year’s G7 summit.
O’Neill’s review is expected to focus on the development and regulation of antibiotics. The initial £500,000 (US$857,000) cost of the work will be met by the Wellcome Trust, an independent charity funding research to improve human and animal health. The British Department of Health said the review would come up with a plan for encouraging and accelerating the discovery and development of new generations of antibiotics.
In particular, it is to consider: how to make investment in new antibiotics more attractive to pharmaceutical firms; the balance between effective and sustainable incentives for investment; how governments and other fund-raisers can stimulate investment in new antimicrobials; and increasing international cooperation, including working much closer with poorer countries.
The review will present its initial findings next year with a final report and recommendations to then follow in 2016. The process will run alongside the WHO’s development of a global action plan on antimicrobial resistance.
Cameron has described the emergence of untreatable bacteria as one of the biggest health threats facing the world today.
“This is not some distant threat, but something happening right now,” he told the Times. “If we fail to act, we are looking at an almost unthinkable scenario where antibiotics no longer work and we are cast back into the dark ages of medicine, where treatable infections and injuries will kill once again. That simply cannot be allowed to happen and I want to see a stronger, more coherent global response.”
However, experts cautioned that antibiotic resistance is a natural phenomenon that cannot be readily stopped, only managed.
“Developing new antibiotics will help manage the growing problem of resistance to currently available drugs,” said Alan Johnson, an expert in antibiotic resistance surveillance at Public Health England. “Unfortunately, it is not the whole answer, as resistance to any new drugs is also likely to develop over time. At a global level, we need to improve our antibiotic stewardship, and infection prevention and control practices, as well as developing better diagnostic tests so that infections are treated with the most appropriate antibiotic at an early stage. Combined, these actions would help to stem the speed at which resistance to existing and new antibiotics develops, and help to prolong the use of these critically important drugs.”
Mark Dosher, secretary to the Bella Moss Foundation, a pet charity, said: “It has to be recognized that new antibiotics could result in new resistance pathogens, so we have to look into other areas, from hygiene and environment to the lifestyle of individuals, and which people — and animals — are more prone to infection. Cameron’s task force is a good idea — as long as it doesn’t solely focus on the cost and regulation of new drugs. Just concentrating on financial incentives for health companies to create new drugs would be a mistake in the long term.”
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