However, getting reliable data is not always easy. While some countries may be willing to share their data, many – particularly developing countries – have inadequate surveillance systems. Weak systems make it hard for them to identify and counter public health emergencies, let alone routine monitoring of resistance and abuse of antibiotics.
Giving Big Pharma a fillip
One of the main reasons for the antimicrobial-resistance crisis is that pharmaceutical companies have not been investing in developing new antibiotics. As the director general of the WHO, Margaret Chan, noted, only two new classes of antibiotics have reached the market in the last 50 years.
Unless we give pharmaceuticals companies a lot more money, they won’t develop new antibiotics. This is because antibiotics tend to be consumed for a short time, so the return on these drugs is much lower than for drugs for chronic conditions, such as type 2 diabetes or hypertension. The O'Neill report proposed that world leaders commit one billion US dollars to “market entry rewards” – compensation to pharmaceuticals firms for developing unprofitable drugs.
Now that there is growing resistance to antibiotics, doctors are also being urged to avoid prescribing new antibiotics unless they have exhausted all the other available options. Pharmaceutical companies are therefore wary of investing in developing drugs of last resort – drugs whose patents may expire before they have recouped the cost of developing them.
Many pharmaceutical companies are complicit in this crisis because – despite the lack of investment – the powerful pharmaceutical lobby works hard to ensure that governments do not close loopholes that would restrict the widespread use of existing antibiotics. In the US, 70% of antibiotics are used to promote growth in animals. This is a very lucrative market for pharmaceutical companies. Giving them routinely to animals vastly increases their use and the UN’s plan does not address this crucial issue.
Any international agreement that fails to deal with the underlying model of how we research and develop new antibiotics, or how they are used, has little chance of success.