In 2016, the United Nations called for concerted action from governments and various sectors to comprehensively address the implications of antimicrobial resistance, and implement national strategies. The AMR Industry Alliance is the life-sciences industry’s response. It brings together 90 pharmaceutical, diagnostics, generics and biotech companies and trade associations from all around the world who are committed to take actions to curb AMR.

The industry does a lot, but it is not always recognized widely. The Alliance enables us to have a credible voice in political discussions around the world, and to leverage the value that the private sector delivers. 

AMR is already impacting millions of people around the world, and it will only get worse if it is not managed well.

We hope to see a couple of things coming out of this meeting. One is simply to have a good balanced and broad debate on the importance of addressing AMR, which leads to a step up in the political commitments from the leaders of the world to take the urgent actions that are needed. As part of that, defining metrics to measure the progress, and developing a mechanism to hold each other accountable will be important, and we hope that it will be agreed that this should be done.

The other outcome we hope to see is the establishment of an independent panel to generate evidence and data to move forward, as with climate change. AMR challenges are very similar: it is a cross-departmental issue within a government, it is also truly global and cross-sectoral, and it is associated with what economists call “negative externalities”. If I take a lot of antibiotics, I will probably be fine, and they will probably carry on working for me, but it contributes to the rise of resistance which will eventually affect other people somewhere in the world.  The independent panel for climate change has been very influential in the climate change debate, in bringing a rigorous scientific data-driven lens to the issue, which we believe has helped drive progress there. We are really keen to see a similar model brought into the AMR debate.

We launched our call to action in February in New York,  to let the UN missions and other stakeholders know what the private sector thinks should be prioritized. We focus on some concrete policy changes we would like to see:

- Antibiotic research: we are strongly supportive of the need for economic incentives to correct the market failure which exists in antibiotics. That will address the lack of pipeline for new antibiotics,  and also the issue we recently highlighted in our “Leaving the Lab” report, which shows that, in many cases, researchers who have successfully developed a new antibiotic work for small biotech companies that go bankrupt because the sales are so low that they just can’t survive. Over 80% of those researchers then choose to work in other areas, such as cancer or immunology.

- Appropriate use of antibiotics: we call for member states to use diagnostic tests, invest in laboratory infrastructure, define clear guidelines on which antibiotics should be used for which patients, and make sure that those guidelines are actually followed.

- Equitable access: we recommend a set of reforms to improve the way that data is collected and surveillance is done, to better understand the magnitude of the problem, and also enable better forecasting for the amount and type of antibiotics needed around the world. Companies are actually stopping to produce some antibiotics because they can’t see that there is a sufficient demand for them that makes it worth their while continuing. Of course, we also still need to improve the way antibiotics and diagnostics are procured and distributed in many countries. Our “Equitable & Responsible Access Roadmap”, launched in parallel with our call to action, addresses barriers that are limiting access for patients around the world, and for which there is opportunity for progress.

- Manufacturing: we urge governments and major procurers of antibiotics around the world to adopt the independent certification scheme we launched last year with the British Standards Institution to validate responsible manufacturing of antibiotics in the global supply chain..

The role of diagnostics is essential in appropriate use of antimicrobials.  With COVID-19, many countries around the world invested in laboratory infrastructure and capabilities at a bigger scale. Sadly, that has not lasted. As COVID-19 faded, a lot of that capability was rapidly wound down. Diagnostics should be brought everywhere into standard practice. The challenge is much broader than simply within AMR. When you look at other disease areas, many patients, and in some countries most patients, are not diagnosed and sometimes not even aware that they have a disease. Within antibiotics, in particular, we are getting to the point where diagnostics can be used rapidly, at the bedside, and can give a clear guidance to doctors of what type of antibiotic to use. Having that capability rolled out widely will make the biggest difference to prescribing decisions, and thereby to the evolution of resistance.

We hope that our recent report on the impact of diagnostics in the fight against AMR, which highlights successful examples in low- or middle-income countries, will help include diagnostics in more national action plans.