The ‘Silent Pandemic’ of Antimicrobial Resistance – Lessons Learned From COVID-19
GHC Webinar – ‘What Lessons from COVID-19 For Advancing Antibiotic R&D?
Clockwise, moderator Suerie Moon, Manica Balasegaram (GARDP), Michelle Childs (DNDi)

In the midst of the COVID-19 pandemic, a “silent pandemic” of drug resistance to mutated bacteria, viruses and parasites is gaining ground and requires major government investments in antibiotic research and development (R&D), a group of experts has warned.

“People are dying across the world from drug-resistant infections. This is a problem of today, and it’s a problem that’s getting worse,” said Manica Balasegaram, Executive Director of the Global Antibiotic Research Development and Partnership (GARDP), during a webinar on antimicrobial resistance (AMR) hosted by the Geneva Graduate Institute Global Health Centre

The Geneva symposium, held on Thursday, highlighted key lessons learned from COVID-19 when looking towards the future of AMR and preparing for the next public health emergency. 

Increased Investment In AMR as a Global Health Priority 

amr pandemic
An antimicrobial is an agent that kills microorganisms or stops their growth. Antimicrobial medicines can be grouped according to the microorganism they act primarily against.

Advancing antibiotic R&D requires global health to invest in AMR as a public health issue in its own right, as antibiotics are going to be a critical tool in pandemic preparedness.

One of the benefits of AMR is that, due to its extensive R&D, researchers know the pathogens behind it, which makes it a global issue that can be prepared for, Balasegaram added. 

“We have to ensure access, particularly diagnostics, treatments, vaccines, and other tools – for infection, prevention, and control. We need to see this not just in terms of AMR but as a cornerstone for pandemic preparedness,” he added.

Although there has been a lot of progress in relation to vaccines, Michelle Childs, Director of Policy Advocacy at Drugs for Neglected Diseases Initiative (DNDi), spoke of the “acute need” to invest in COVID-19 effective treatments.

Childs addressed the need to have “well-powered, adaptive, clinical trials” to see if these treatments can be successful in repurposed and novel technologies, as well as a need to hone in on specific COVID-19 treatments, especially for those with mild to moderate symptoms of the virus.

“Potentially, those treatments could not just stop progression but could offer some hope for post-COVID symptoms,” she said. “We need to invest in virus-agnostic types of treatment in the early stages and discovery, not just for COVID but also for future pandemics.” 

Innovation in Global Health Needed, Shift Away from Traditional Sources 

The World Bank only releases funds to products qualified by the FDA

Global health actors also need to set their priorities towards innovation, as they reframe the way AMR is viewed, said Childs. She added that the level of innovation demonstrated during the COVID-19 pandemic should be applied to the future. 

“We need to ensure that when we’re looking for innovations, we don’t just look in the traditional sources in high-income countries.”

Childs also addressed the need to shift away from a “dependence on stringent regulatory agencies”, citing the negative effects on funding and access with the World Bank, for example, which only releases funds to buy products qualified by the FDA. 

“We need to strengthen further and respect the growing regulatory capacity worldwide. We have to move away from just a reliance solely on the EMA and the FDA,” said Childs, raising the African Vaccine Regulatory Forum as an example.  

Inequitable Global Response Prolongs the Pandemic

A health worker wearing personal protective equipment (PPE) carries a patient suffering from COVID-19 outside the casualty ward at Guru Teg Bahadur Hospital, in New Delhi, India.

Many of the lessons of COVID-19 are still ongoing, the most prominent being lessons on inequitable global response. The US was experiencing a drop in coronavirus cases with increasing vaccinations, while countries such as India are facing their worst outbreaks of COVID-19.

“We can’t really lift ourselves out of this situation unless we have a global response and that means global access. Inequitable access to medical countermeasures will have devastating consequences, and will prolong the pandemic,” said Balasegaram.

“If we don’t fix this now, then we’re going to face this again in AMR, and every other health issue that follows.” 

Intellectual Property Restrictions – Inequitable Access

IP

 

“We can’t really talk about lessons for COVID for the innovation system without addressing the real issues that we’re facing with COVID now,” said Childs. 

One of these issues concerns intellectual property, which comes days after nearly 400 members of the European Parliament (MEPs) and national parliaments across the European Union issued a joint appeal calling for the European Commission to drop its opposition to a proposed WTO waiver on IP related to COVID-19 health technologies for the duration of the pandemic. 

“[Lifting the restrictions allows] the vaccine recipe to be shared for countries [so they are able] to support themselves, [sharing] the know-how of technologies using some of the processes that are already available. We can’t rely on business as usual, or just rely on private licensing deals, which are inadequate.”

Image Credits: Staicon Life/Flickr, GHC, Felton Davis/Flickr, REUTERS/Adnan Abidi/Flickr, Open Source/Flickr.

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