Tackling Drug-resistant Infections Globally: Final Report And Recommendations

Generated Summary

This document is the final report from the Review on Antimicrobial Resistance (AMR), commissioned by the UK Prime Minister and supported by the Wellcome Trust and UK Government. The review, chaired by Jim O’Neill, examines the economic perspective of AMR and provides recommendations to address the growing global problem of drug-resistant infections. The report employs a range of research methods, including economic analysis, expert consultations, and the review of existing literature, to assess the magnitude of the problem and propose solutions. The focus is on a global approach, with the goal of reducing the demand for antimicrobials, increasing the supply of effective antimicrobials, and building a global coalition for action. This summary provides an overview of the key findings, statistics, and recommendations outlined in the report.

Key Findings & Statistics

• It is estimated that by 2050, 10 million lives a year could be at risk due to the rise of drug-resistant infections.
• The cumulative economic cost of inaction by 2050 could reach 100 trillion USD.
• 700,000 people die every year from drug-resistant infections, HIV, TB, and malaria.
• 200,000 people die every year from multidrug-resistant and extremely drug-resistant tuberculosis (TB) alone.
• Antibiotic-resistant neonatal infections cause the deaths of nearly 60,000 newborns each year in India.
• In the US alone, more than two million infections a year are caused by bacteria that are resistant to at least first-line antibiotic treatments, costing the US health system 20 billion USD in excess costs each year.
• The burden of deaths from AMR could balloon to 10 million lives each year by 2050, at a cumulative cost to global economic output of 100 trillion USD.
• If no action is taken by 2050, the death toll could be a staggering one person every three seconds.
• The US government allocated 5.4 billion USD in a single year to underwrite its response to the Ebola epidemic globally and domestically.
• The UK spent 1.9 billion USD tackling the 2009 swine flu outbreak.
• The cost of running a sustained public awareness campaign across the world could cost between 40 and 100 million USD a year.
• In the US, over 70 percent (by weight) of the antibiotics defined as medically important for humans by the US Food and Drug Administration (FDA) are sold for use in animals.
• Across four middle-income countries, close to 500 million courses of antibiotics are each year used to treat diarrhoea.
• Investment in water and sanitation infrastructure in a country by 50 percent is correlated with around nine and a half years of additional life expectancy for its population.
• In the US, the use of pneumococcal conjugate vaccines led to a 64 percent reduction in antibiotic-resistant pneumococcal infections among children and a 45 percent decrease among adults over 65 years of age.
• The total market for antibiotics is relatively large, with sales of about 40 billion USD a year, but only about 4.7 billion USD of this total comes from patented antibiotics.
• Of 38 billion USD venture capital invested into pharmaceutical R&D between 2003 and 2013, only 1.8 billion USD was invested into antimicrobials research.
• The US National Institutes of Health (NIH), allocated just 1.2 percent of its grant funding to AMR-related research between 2009 and 2014.
• Based on scenarios of rising drug resistance for six pathogens to 2050, we estimated that unless action is taken, the burden of deaths from AMR could balloon to 10 million lives each year by 2050, at a cumulative cost to global economic output of 100 trillion USD.

Other Important Findings

• The report emphasizes that drug resistance is a major threat to global health, with current interventions being insufficient to address the problem.
• The authors highlight the link between antibiotic use in animals and humans, urging a reduction in unnecessary use in agriculture and aquaculture.
• The report suggests that the rise in drug resistance is linked to poverty, and the lack of access to clean water and sanitation.
• The report emphasizes the need for new diagnostics to guide the use of antibiotics, advocating for a system of market entry rewards.
• The report acknowledges the lack of investment in R&D for antibiotics and offers recommendations, including a Global Innovation Fund.
• The report highlights that TB drug development faces unique challenges due to the need for combination therapies and the low incomes of those affected.

Limitations Noted in the Document

• The report’s recommendations are based on estimates and projections, which may vary from reality.
• The report acknowledges that the cost estimates for some interventions are difficult to determine precisely due to the complexity of the products and the varying needs of different populations.
• The report highlights the lack of detailed data in certain areas, particularly regarding antibiotic use in agriculture and the environment, which limits the precision of the analysis.
• The report acknowledges the complexity of implementing coordinated interventions on a global scale, where factors such as political will and economic considerations can vary greatly.

Conclusion

The Review on Antimicrobial Resistance underscores the urgency and the economic imperative of addressing the global challenge of AMR. The report’s central message is that the current trajectory, marked by increasing drug resistance and insufficient new drugs, poses a severe threat to human health and the global economy. The authors emphasize that inaction is not an option. Key to the solution are a multi-pronged approach: reducing the demand for antibiotics, increasing the supply of new antimicrobial drugs, and fostering a global coalition for action. The report highlights the importance of a global public awareness campaign to educate the public, alongside improvements in sanitation and hygiene practices to prevent infections. Crucially, the authors emphasize the need for a significant shift in incentives to pharmaceutical companies and others to create a long-term solution to this problem, with new rewards, funded globally, that support the development of new antibiotics and ensure access to antibiotics in the developing world. The report calls for increased funding and sustained efforts in surveillance, with data sharing and coordinated action among various stakeholders. Furthermore, the review stresses the significance of addressing the issue of TB, which is both a major threat in its own right and intrinsically linked to the broader issues of AMR. The overarching message is clear: the investment needed to tackle action is dwarfed by the human and financial cost of inaction which is mounting already.