WHO: Lack of new antibiotics threatens global efforts to contain drug-resistant infections

19 January, 2020

Extracts and a comment from me below. Full text: https://www.who.int/news-room/detail/17-01-2020-lack-of-new-antibiotics-...

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Lack of new antibiotics threatens global efforts to contain drug-resistant infections

17 January 2020 News release Geneva

Declining private investment and lack of innovation in the development of new antibiotics are undermining efforts to combat drug-resistant infections, says the World Health Organization (WHO).

Two new reports reveal a weak pipeline for antibiotic agents. The 60 products in development (50 antibiotics and 10 biologics) bring little benefit over existing treatments and very few target the most critical resistant bacteria (Gram-negative bacteria).

While pre-clinical candidates (those in early-stage testing) are more innovative, it will take years before they reach patients.

“Never has the threat of antimicrobial resistance been more immediate and the need for solutions more urgent,” says Dr Tedros Adhanom Ghebreyesus, Director-General of WHO. “Numerous initiatives are underway to reduce resistance, but we also need countries and the pharmaceutical industry to step up and contribute with sustainable funding and innovative new medicines.”...

WHO on AMR

New treatments alone will not be sufficient to combat the threat of antimicrobial resistance. WHO works with countries and partners to improve infection prevention and control and to foster appropriate use of existing and future antibiotics...

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Comment (Neil PW): I have made this point many times on HIFA but I'll say it again... Despite a few new initiatives - notably the Commonwealth Partnerships for Antimicrobial Stewardship Programme (CwPAMS) - political and financial investment 'to foster appropriate use of existing antibiotics' is woefully inadequate. Appropriate use of antibiotics requires a multifaceted approach that has previously been described by WHO but is not being adequately implemented. Part of this approach is to ensure that all prescribers and users of antibiotics are able to access reliable information and guidance on when and how to prescribe and use antibiotics appropriately. HIFA has been arguing for several years the need to grasp this vital and low-hanging fruit. Meanwhile, 'Globally, most prescribers receive most of their prescribing information from the pharmaceutical industry and in many countries this is the only information they receive.' World Medicines Report, WHO (2011). Reliable information on individual medicines is relatively easy to access (at least for those who speak English and have access to internet). But this is inadequate - what is needed is information on how appropriately to select medicines in different clinical contexts. Such information used to be made freely available by the British National Formulary, but several years ago the BNF blocked free access outside the UK (except via Hinari - see below). Nowadays, 20-year-old tattered print copies of the BNF continue to be used around the world. The BNF is available electronically via Hinari, but only through point-of-care stable internet connection, which is impossible for the vast majority of users. In my view an international version of the 'BNF' is needed that would cover selection guidance on all commonly used medicines and would be freely available to all for offline use on mobile phones. Technically, drawing on the experience and expertise of the BNF and others, this would be relatively straightforward and would have a global impact. All it needs is a modest amount of political commitment and financial investment. A drop in the ocean compared with the growing AMR crisis.

Best wishes, Neil

Joint Coordinator HIFA Project on Information for Prescribers and Users of Medicines - http://www.hifa.org/projects/prescribers-and-users-medicines (sponsorship opportunity - contact neil@hifa.org )

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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - www.hifa.org ), a global community with more than 19,000 members in 177 countries, interacting on six global forums in four languages. Twitter: @hifa_org FB: facebook.com/HIFAdotORG neil@hifa.org