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More action needed on antibiotic resistance

Published on 25/07/14 at 09:58am
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The Medical Research Council building in London

Pharma and governments need to put their heads together urgently in order to tackle the threat of antimicrobial resistance (AMR), warn manufacturers and researchers. 

AMR – which encompasses resistance to antibiotics and other drugs to treat infections caused by microbes such as parasites, viruses and fungi – has been grabbing headlines this year. 

The World Health Organization (WHO) has gone so far as to warn that common infections will become “a major threat to public health” causing deaths on a massive scale

“Government-funded research and pharma need to work better together to ensure that the fundamental science research base can help to feed into the pipeline,” Des Walsh, head of infections and immunity at the Medical Research Council (MRC), tells Pharmafocus. 

“We need to try and engage more with pharma at a science level: we need to pick their brains more to find out why things didn’t work or what needs to be tweaked,” he adds.

The MRC recently announced it is to lead an initiative backed by eight government bodies and the Wellcome Trust, co-ordinating the work of medical researchers and biologists as well as apparently less likely resources such as engineers, vets, economists, social scientists and mathematicians. 

This is because the problem of AMR extends far beyond human health with livestock increasingly being infected with antibiotic-resistant bacteria. 

“The UK is traditionally very strong in global health research and there’s a huge breadth of issues: animals, the environment, waterways, agriculture,” Walsh continues. “Very poor countries are fighting this on the front line. The UK is not being affected as much as some but we should not be complacent. Bugs know no borders: they can get on a plane.”

UK prime minister David Cameron, concerned about medicine once again entering the ‘dark ages’, has announced a review into why so few anti-microbial drugs have been introduced in recent years – but a parliamentary report warned this did not show sufficient urgency.

And the Science and Technology Committee agrees that collaboration between different areas of research is paramount in tackling AMR.

But antibiotic research has been falling out of favour with drug companies as they focus research upon more lucrative fields. Walsh suggests the emphasis in pharma a decade or more ago was on viral infection, rather than microbial diseases. 

“There was a real drive towards HIV and flu, for example, and great strides were made,” Walsh points out. “Maybe the eye was taken off the ball because there were pressing needs, and we had antimicrobials that worked.” 

But he believes all is far from lost because pharma still has access to the work it was doing more widely in antimicrobials. Getting research and pharma closer together would “give pharma sight of some of the funky science that’s coming through universities”, he adds. 

Pharma’s role

GlaxoSmithKline is one of only a handful of companies that still has an active antibiotics pipeline but believes new approaches are needed if more companies are to be encouraged to invest in this area. 

“This needs to include new economic models and more open-minded approaches to sharing information and working with partners across the public and private sectors,” a GSK spokesperson tells Pharmafocus.

There is certainly a limited amount that pharma can be expected to do on its own, Walsh believes. “There is a window of opportunity we need to grab hold of but we need a co-ordinated approach,” he says. “In the UK, for example, we have an excellent research infrastructure: there is lots of work being done but it is not pulled together.” 

AstraZeneca has one of the most promising pipelines featuring antibiotics, but said in May it was considering leaving the field to focus more on areas such as cancer and heart disease. 

“It is essential that government and industry work together to find a solution,” an AstraZeneca spokesperson says. “There are currently considerable barriers to investment in the development of new antibiotics.” 

In particular, this means “the commercial environment for new antibiotics needs to better reflect the value of these life-saving treatments by balancing prudent use in order to minimise AMR, together with the availability of new drugs to fight existing and future pathogens”.

A renewed focus on generating knowledge and technologies from which new types of antimicrobials and diagnostics could be invented – along with greater incentives for industry to develop novel antibiotics – are AstraZeneca’s suggestions. 

“Any initiative that seeks to overcome the scientific, regulatory and financial barriers to antibiotic development – such as the UK government’s commissioning an independent review to explore the economic issues surrounding AMR – is a positive step forward,” AZ concludes.

Adam Hill

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