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return. As such, there is little incentive for the
pharmaceutical industry to dedicate its resources
to antibiotic research.
On the other hand, we seem to have exhausted
our ideas on ways to kill or immobilise bacteria.
There is therefore a need for real innovation in
this area, so any initiative to support this, such
as the new European Clinical Trials Directive, is
a welcome step in this direction.
However, there is not only need for new (classes
of) antibiotics, but also for new incentives and
broader partnerships to support a more
comprehensive approach to ensuring that future
generations can continue to rely on modern
medicine. This requires an increase in public-
private partnership (PPP) between the
pharmaceutical industry, academia, national
governments, regulatory agencies, civil society,
technical networks and international organisations.
We should also reach an agreement on what to
do when we finally have new antibiotics developed
and ready to enter the market. This is called
‘Controlled Distribution and Use of new Antibiotics’
(CDUA) to avoid the type of distribution, sales and
use which has driven us to the current situation.
Taking this into account, efforts are now directed
towards defining innovative incentives and
developing new business models that stimulate
research and discourage the aggressivemarketing
of new antibiotics. The main components of a new
business model would include: de-linking return
of investment from sales; controlled use and
distribution of new antibiotics; equitable global
access and affordability.
In addition to searching for new antibiotics,
research is increasingly focusing on finding
alternatives to antibiotics, which is also fundamental
in the fight against antimicrobial resistance.
Similarly, efforts are on-going in collaboration with the University of Antwerp
to set up a network for the surveillance of antimicrobial consumption in
non-EU countries in the European Region, compatible to the European
Surveillance of Antimicrobial Consumption Network (ESAC-Net) hosted by
ECDC. A harmonised and co-ordinated surveillance network in all countries
in the European region is key to protect health from a cross-border threat.
The 2011 strategic plan
In September 2011, in Baku, Azerbaijan, at the WHO Regional Committee
for Europe, 53 countries adopted a new European strategic action plan
on antibiotic resistance. Developed by the WHO Regional Office for
Europe following extensive consultation with experts and policy makers
and based on the latest research, the action plan builds on the
momentum created by World Health Day 2011, with its slogan of ‘No
action today, no cure tomorrow’.
The plan calls upon strong national co-ordination between relevant
sectors and identifies key areas where action must be taken to ensure
that Europeans are safe, including the surveillance of antibiotic resistance
and consumption, infection prevention and control, innovation and
research, prevention of antibiotic resistance in the veterinary and
agricultural sectors, and awareness raising.
Member states are urged to ensure political commitment and resources
to implement the WHO Global Strategy for containment of Antimicrobial
Resistance through the European Strategic Action Plan for Antibiotic
Resistance, identifying key national priorities from its seven strategic
directions as part of national plans. The WHO Regional Office and partners
are working together with governments in the European region to
implement this comprehensive strategic action plan.
The Clinical Trials Directive
For more than 25 years, we have witnessed an alarming trend of increasing
antibiotic resistance together with a sharp decrease in the development of
new antibiotic classes.
Awareness is growing that very few new antibiotics, diagnostics or vaccines
are in the research and development (R&D) pipeline. There are several
reasons for this: discovering new antibiotics is a very complex and lengthy
process that implies substantial economic investments with a potential low
Dr Danilo Lo Fo Wong
Senior Adviser on
Antimicrobial Resistance
World Health Organization (WHO)
Regional Office for Europe
browse
For more than 25 years,
we have witnessed an
alarming trend of
increasing antibiotic
resistance together
with a sharp decrease
in the development of
new antibiotic classes
ANTIMICROBIAL RESISTANCE
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