Solving Antibiotic Resistance

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160414 Solving Antibiotic Resistance

During this STOA Working Breakfast co-organised by EuChemS, and EFMC on the 28 April 2016, researchers and several Members of the European Parliament analysed the global challenge of antimicrobial resistance and weighted the pros and cons of possible solutions.

Antimicrobial Resistance (AMR) is the ability of microorganisms to withstand attack by antimicrobial drugs such as antibiotics, antifungal or antivirals, and is a serious issue that threatens to render many of the treatments we use today ineffective in the future – from tuberculosis to HIV, from pneumonia to other common infections.

(the report is available here)

Workshop Outcomes – Forward Look

This workshop attracted a capacity audience including at least six MEPs. It was chaired by Paul Rübig MEP, Chair of STOA.

Clear recommendations emerged from the Workshop. These include:

  • Antimicrobial resistance, of which antibiotic resistance is a subset, is a current problem in Europe that could become much worse; it is an even more serious problem in developing countries.
  • Better use of current antimicrobials is essential. This should include:
    • Enforcement of the ban on using antimicrobials in agriculture for anything other than treating disease
    • A major advertising campaign to ensure prescribed doses of antimicrobials are taken to completion
    • Better diagnostics to help doctors identify the correct antimicrobial to use
    • Ensuring that all doctors know when antimicrobial treatment is required
  • In addition to the better use of current antimicrobials, novel antimicrobials are urgently needed to treat multiresistant microbes.
  • Pharmaceutical companies will not, on their own, tackle antimicrobial resistance, because there is presently a predicted negative return on investment for a new antimicrobial drug.
  • Antimicrobial resistance should not be considered as a problem to be addressed in isolation, but in conjunction with efforts to address other medical problems of major European concern that are currently not tackled effectively, including e.g. ageing related and psychiatric diseases.
  • There is thus an urgent need for a consortium to be created involving pharmaceutical companies, philanthropists, the EC, and national governments to provide leadership and funding to tackle this problem. This consortium should:
    • Set up 1-3 major focused hubs for medicinal chemistry research in fields including antibacterial/antimicrobial/anti-infective development. The centres should tackle several disease areas in order to ensure continuity of funding and critical mass of activity. Specialist activities, e.g. high throughput screening / crystallography could be carried out in well linked spokes, not necessarily within the hubs
    • in the area of new antimicrobials,
      • principally focus on classes of clinically validated antimicrobials and/or on clinically validated targets
      • be fully equipped for drug discovery and development, mechanistic studies and testing against clinical isolates
      • be equipped to perform in vitro ADMET, in vivo pharmacology and efficacy and DMPK studies either by in house or external capabilities
      • be able to provide leadership in terms of in vitro and in vivo pharmacology, pharmacodynamics, distribution, metabolism and formulation
      • be linked to excellent centres for fundamental research which should also be funded properly
      • be linked to excellent hospitals with research & teaching facilities
      • be able to have access to large populations with microbial infections for significant clinical trials, ideally locally or by partnership
    • fund innovative ideas in key areas wherever they arise
    • link all researchers in the field so that they share all results immediately they are available
    • ensure that some of their research is not hampered by patents and lawyers
  • Such a development is a natural evolution of world leading collaborative activities in Europe. It will cost in excess of €1 bn to fund each centre and its associated researchers.