Report cites progress, but says leading economies need to do more to fight antimicrobial resistance

A new report indicates the world’s leading economies have made progress in their efforts to address antimicrobial resistance (AMR) but need to do more to lessen the health and financial impact of the looming public health crisis.

The report released yesterday by the Global Coalition on Aging and the Infectious Diseases Society of America (IDSA)—the 2024 AMR Preparedness Index Progress Report—assesses the actions taken by 11 high-income nations to address AMR across five categories. It’s a follow-up to a 2021 report that found the same 11 countries were failing to back up their promises with substantive action to fight AMR.

The new report finds the 11 countries—Brazil, Canada, China, France, Germany, Italy, India, Japan, South Korea, the United Kingdom, and the United States—have taken concrete steps in recent years, including renewing national action plans (NAPs) to address AMR, providing funding for those plans, promoting awareness of AMR and antibiotic misuse, collecting surveillance data, and supporting antibiotic stewardship efforts.

But few countries have taken concrete steps to implement pull incentives to boost the weak pipeline for new antibiotics. The report also noted that very few new antibiotics have been approved in the 11 countries since 2021, and even fewer novel antibiotics have been developed in that time. Governments need to make the availability of novel antibiotics a priority and ensure that those antibiotics are accessible and affordable, the authors of the report said.

“It’s imperative that global leaders leverage their power—both separately and collaboratively—to commit and implement concrete actions in the face of growing drug resistance,” Global Coalition on Aging CEO Michael Hodin, PhD, said in a press release. “Without such action, we risk losing antibiotics, and with them, our ability to enjoy the longevity that we do currently.”

Progress on national action plans, appropriate use

Based on a review of published research and policies and interviews and surveys of AMR experts, the report measured the progress of the 11 countries across five key areas of action—national strategy, innovation, access, appropriate and responsible use, and AMR and the environment.

Progress has been made in the 11 countries across all areas, particularly regarding national strategy. China, Canada, France, Italy, and Japan have all released new NAPs since 2021, and most countries have committed funds to their NAPs. In addition, every country has some level of budget available for AMR-related projects, with the United Kingdom and United States providing the most funding.

Regarding appropriate and responsible use, all 11 countries have implemented national initiatives to promote AMR awareness, have some level of antimicrobial stewardship practices in place, and have some degree of AMR education in the curricula for medical training.

“Countries have largely acknowledged the need to optimize antimicrobial usage through stewardship in order to improve patient outcomes and limit the development of resistance, and many have strengthened awareness programs over the past two years,” the report states.

Progress has been slow for efforts to promote innovation and access, however. One of the most significant steps has been taken in the United Kingdom, which has begun implementing a subscription model to pay for new antibiotics—an effort experts believe could help fix the broken market for antibiotics and encourage development of new antibiotics.

Japan has piloted a smaller-sized revenue guarantee model, and a bill that would create a subscription model in the United States (the PASTEUR Act) has been in Congress for several years but has yet to pass, despite bipartisan support.

But more of the world’s leading economies need to pursue similar pull incentives to spur the creation of new antibiotics and fund push incentives that support early-stage antibiotic research and development, the report argues. It also calls for countries to fix the regulatory hurdles that prevent new antibiotics from getting to the market quickly, and reduce the barriers to access.

The report also notes that while more countries are starting to prioritize AMR as a One Health issue that affects people, animals, plants, and the environment, few are actively monitoring for the presence of AMR in the environment: Only four of the 11 countries are performing regular monitoring of water for AMR genes.

To continue making progress, the report calls for all 11 countries to invest more in NAPs and AMR countermeasures, further strengthen AMR and antibiotic consumption surveillance systems, support data collection on AMR in the environments, and boost funding for infectious disease medicine.

A pivotal year

At a webinar yesterday to launch the report, Hodin and others said they hope the report highlights some of the issues that need to be addressed at the upcoming United Nations high-level meeting on AMR in September.

“We hope this progress report will help all of us to continue to advance urgently needed policies and endeavors in this area,” said Neil Clancy, MD, an infectious diseases physician and researcher the University of Pittsburgh and a member of IDSA’s AMR Committee. He called 2024 a “pivotal year” in the fight against AMR.

Dame Sally Davies, the UK Special Envoy on AMR, said that while the global system has been “slowly but surely” gearing up to fight AMR over the last decade, greater urgency from world leaders is needed.

“There’s a lot happening globally that we can celebrate and build on…but now it’s about mobilizing the evidence and data for collaboration and political action,” Davies said. “We need global leaders to move faster than these superbugs that they’re trying to beat, and it’s a long game.

Source: University of Minnesota, CIDRAP

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