Hospital Lead, Pfizer UK
Antimicrobial resistance (AMR) is one of the top global threats facing society and urgent action is critical to mitigate its impact. Yet despite the major challenges we face in tackling this growing health threat, there is still hope: it’s not too late to turn the tide.
The threat of AMR in context
In a study published by The Lancet, researchers calculated an estimated 4.95 million deaths globally were associated with bacterial AMR in 2019 alone.1 And in the UK every year, at least 12,000 people die from AMR2 – roughly the same number of lives lost to breast cancer.
Whilst these statistics are shocking, we stand at a unique moment in time with the opportunity to take a huge step forward in our fight against AMR.
Firstly, reflecting on the early days of the COVID-19 pandemic, we became acutely aware of the devastating consequences of an untreatable infection. Secondly, we have much better understanding that our own health relies on the health of those around us – people in our households, our communities, and even those living thousands of miles away. The pandemic has made the world feel smaller, more interconnected and more united, and this is a powerful force in the face of global public health threats like AMR.
The race is on
Currently ‘superbugs’ are emerging faster than new antibiotics can reach the market, with no new class of antibiotics being developed since the 1980s.3 Many people in the field talk about a ‘discovery void’, but is this too simplistic?
A strong pipeline of new antibiotics is essential to tackle the rising tide of AMR and, from an industry and investor perspective, we recognise that we need work collaboratively to prioritise antimicrobial R&D. However, there is much more at play when it comes to the discovery of new medicines.
The journey from discovery to a clinically approved medicine is long and the failure rate is high. Developing new antimicrobials requires huge financial investment – in excess of $1 billion3 – and once approved are often used sparingly to support good stewardship. This creates a challenging dichotomy: needing to preserve public health, while making it difficult to recover the high costs associated with antimicrobial development. To solve this, we must re-think how we incentivise R&D.
It’s time to think differently
Despite the huge economic and societal burden of AMR, global healthcare systems have been slow to fully recognise the value of antimicrobials, but this is changing. Traditional approaches to antimicrobial evaluation and reimbursement aren’t working and there is a clear need for innovative assessments to understand the total value of antimicrobials that may be left on a very high shelf until it’s needed.
Pioneering work in this area is already underway. Pfizer has partnered with NHS England, NICE and the UK government to pilot a world-first innovative reimbursement model for antimicrobials. This initiative is a first step in assessing the broader value that antibiotics bring to people and society through the ‘STEDI’ values:4
Spectrum: Benefits of being able to treat with a narrow-spectrum agent in some settings
Transmission: Benefits from avoiding the spread of infection
Enablement: Benefits from making it safe to receive medical care
Diversity: Using varied antibiotics reduces resistance pressure
Insurance: Value of having an antibiotic to hand in case of sudden need
Hope on the horizon
Cross-industry collaboration is crucial to tackle AMR head on, with the same urgency as our response to COVID-19. Pfizer is a proud member of the AMR Industry Alliance, a coalition of over 100 biotech, diagnostics, generics and research-based pharmaceutical companies and associations.5 Alliance members are currently investigating 93 products or technologies covering ‘traditional’ antibiotics and antifungals, vaccines, diagnostic platforms, assays and non-traditional or other products.
Outside of the industry there is some fascinating research taking place here in the UK. A team of international researchers, at the University of Portsmouth is using supercomputers to redesign existing antibiotics.6 And researchers at the University of Manchester have found a way to produce complex antibiotics through gene-editing.7 This kind of ‘out of the box’ thinking holds huge promise for the fight against AMR.
And the next generation of scientists are already getting involved. The ‘Swab and Send’ initiative based at the Liverpool School of Tropical Medicine encourages children to swab their homes, gardens and local areas to help scientists identify new antibiotic compounds.8 Indeed, the next antibiotic could be discovered thanks to a child who hasn’t even started school – if you’re looking for hope, look no further!