Internationally focused commission on antimicrobial resistance announced by PM

Increasingly, bacteria, parasites, viruses and other disease-causing microorganisms are becoming resistant to the drugs we have available. However, no new classes of antibiotic drugs have come on the market for more than 25 years, and the drugs we do have are over-prescribed.

The major international review will look broadly at the economic issues surrounding antimicrobial resistance, including how to incentivise the drug pipeline so that new drugs are developed, but also focus on our relationship with existing antimicrobials and how they can be used better to treat illness.

The review will be led by renowned economist Jim O’Neill, with backing from the Department of Health and HM Treasury. The Wellcome Trust is contributing £500,000 to the commission, which will run for an initial period of one year at the Trust’s offices in London with a small staff.

The review will examine:

• the development, use and regulatory environment of antimicrobials, especially antibiotics, and explore how to make investment in new antibiotics more attractive to pharmaceutical companies and other funding bodies
• the balance between effective and sustainable incentives for investment, and the need to conserve antimicrobial drugs so they remain effective for as long as possible
• how governments and other funders can stimulate investment in new antimicrobials, and timeframes and mechanisms for implementation
• increasing international cooperation and support for action by the international community, including much closer working with low- and middle-income countries on this issue.

Jim O’Neill will work independently of government, and will have full freedom to approach the issues and the evidence as he sees fit.

He will bring together a panel of international experts to cover all aspects of the antimicrobial resistance pipeline and associated economic issues, and identify a range of proposals that can form the basis of a new, strengthened global effort. Jim O'Neill will start work on the independent review in the autumn once his report on City Growth is published.

The announcement of the review comes a week after antimicrobial resistance was chosen by the public as the winner of the £10 million Longitude Prize, with a focus on creating a cheap, accurate and easy-to-use test for bacterial infections that will allow doctors and nurses to better target antibiotics and prevent over-use.

The Prime Minister, David Cameron, said: “Resistance to antibiotics is now a very real and worrying threat, as bacteria mutate to become immune to their effects.

“With some 25,000 people a year already dying from infections resistant to antibiotic drugs in Europe alone, this is not some distant threat but something happening right now.

“If we fail to act, we are looking at an almost unthinkable scenario where antibiotics no longer work and we are cast back into the dark ages of medicine where treatable infections and injuries will kill once again.

“That simply cannot be allowed to happened and I want to see a stronger, more coherent global response, with nations, business and the world of science working together to up our game in the field of antibiotics.

“Following discussions at the G7 last month, I have asked the economist Jim O’Neill to work with a panel of experts and report back to me and other world leaders on how we can accelerate the discovery and development of a new generation of antibiotics.”

Professor Dame Sally Davies, Chief Medical Officer for England, said: “The soaring number of antibiotic-resistant infections poses such a great threat to society that in 20 years’ time we could be taken back to a 19th-century environment where everyday infections kill us as a result of routine operations. We have reached a critical point and must act now on a global scale to slow down antimicrobial resistance. In Europe, 25,000 people a year already die from infections which are resistant to our drugs of last resort. The biotech and pharmaceutical industry will be central to resolving this crisis which will impact on all areas of modern medicine. We cannot tackle the problem on our own and urgently need coordinated international action, which is why I am delighted to see the Prime Minister taking a global lead by commissioning this review.”

Jeremy Farrar, Director of the Wellcome Trust, said: “Drug-resistant bacteria, viruses and parasites are driving a global health crisis. It threatens not only our ability to treat deadly infections, but almost every aspect of modern medicine: from cancer treatment to caesarean sections, therapies that save thousands of lives every day rely on antibiotics that could soon be lost. We are failing to contain the rise of resistance, and failing to develop new drugs to replace those that no longer work. We are heading for a post-antibiotic age.

“This is not just a scientific and medical challenge, but an economic and social one too. I am thus delighted that an economist of the stature of Jim O’Neill has agreed to investigate these issues, with an eye on the incentives, regulatory systems and behavioural changes that will be required to resolve them. The Wellcome Trust is proud to fund and host Jim and his team as they conduct this vital work.”

Dr Jim O’Neill said: “I am delighted and honoured to be asked by the Prime Minister to undertake this review. The emergence of drug-resistant infections and the lack of a sustainable pipeline of antimicrobial drugs are mounting threats to society, and it’s clear that international action is needed now if we are to prevent lives being lost unnecessarily. As someone who has been immersed in how the world may develop, finding ways to stop this problem is a very exciting challenge.”

Dr Margaret Chan, Director General of the World Health Organization (WHO), said: “The UK is demonstrating strong leadership in raising awareness about the global threat posed by antimicrobial resistance. Forming this review is a crucial step towards ensuring that the world has effective medicines to combat infectious diseases. WHO will work closely with the review and other key partners on this important initiative.”

The review will present its initial findings during 2015, with a final report and recommendations to follow during 2016. This process will run alongside – and engage closely with – the WHO’s development of a Global Action Plan on AMR (antimicrobial resistance).

The Resolution on Antimicrobial Resistance passed at last month’s World Health Assembly in Geneva recognised the pressing need for the global community to act immediately in the fight to combat increasing resistance.