The Wrong Remedy: What Proposed Pull Incentives for Antimicrobial Research & Development Ignore About Antimicrobial Resistance (AMR) [Guest Essay]
Newsletter Edition #224 [The Files In-Depth]
Hi,
Today we bring you a guest essay by activists at the Médecins Sans Frontières.
The authors suggest ways to make investments into research and development to address Antimicrobial Resistance (AMR) in a way that improves equitable access to these crucial and urgent medical products, without further contributing to monopolies.
In bid to attract investments into this important but under-invested sector, governments are luring companies. Activists worry that such efforts “tend to preserve and/or bolster the standard model for incentivizing R&D” where private sector’s pursuit of profit is the primary driver of innovation. This model, they argue is not suitable to antimicrobials “because these drugs must be introduced in a responsible way and used judiciously to preserve their efficacy and at the same time are needed right away in low-resource contexts that struggle to access costly new tools.”
This is a timely read ahead of the UN General Assembly High-Level Meeting on antimicrobial resistance 2024 in September.
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I. GUEST ESSAY
The Wrong Remedy: What Proposed Pull Incentives for Antimicrobial Research & Development Ignore About Antimicrobial Resistance (AMR)
Ava Alkon, Global Health Advocacy and Policy Advisor, MSF USA; Dušan Jasovský, Antimicrobial Resistance Pharmacist, MSF Access Campaign; Shailly Gupta, Senior Communications Advisor, MSF Access Campaign.
contact: ava.alkon@newyork.msf.org
Ahead of the second UN High-Level Meeting on antimicrobial resistance (AMR) scheduled for September 2024, member states are negotiating a political declaration meant to strengthen and accelerate the world’s response to address drug-resistant infections - a global health crisis that is taking millions of lives and threatening decades of medical progress.
As a medical humanitarian organization that has treated thousands of people with drug-resistant infections, and one that actively addresses AMR in our projects around the world, Médecins Sans Frontières/Doctors Without Borders (MSF) sees an urgent need to strengthen the ability of health systems worldwide to prevent, detect, and respond to drug resistance. Among other measures, this requires more international support to improve infection prevention and control and antimicrobial stewardship, expand microbiological laboratory capacity, and ensure patients have access to the diagnostic tests and antimicrobials they need – both older and new ones.
Alarmed by a dearth of promising novel antimicrobials in the development pipeline, high-income country governments are now considering making major new financial commitments to stimulate research and development (R&D) for treatments to fight drug-resistant infections. While novel treatments are just one piece of the picture of what is needed for the world to get ahead of AMR, we agree that the fact that so few are forthcoming is of great concern.
A report released by the World Health Organization (WHO) in June 2024 indicated that recently approved antibacterial agents and those in the clinical R&D pipeline continue to fall far short of what is needed to counter the escalating threat of AMR.
And indeed, existing treatments are failing fastest in contexts like those where MSF provides care because low- and middle-income countries (LMICs) bear the highest burden of AMR, and humanitarian settings are at especially high risk.
We are gravely concerned, however, that some methods currently proposed for incentivizing R&D will actually prevent timely and equitable access to new treatments for people who need them the most and divert resources away from other necessary measures.
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