The overprescribing of antibiotics is one factor behind the alarming rise of "superbugs," says a blue ribbon commission. (MIGUEL MEDINA/AFP/GettyImages)

New Plan Looks to Keep Superbugs from Killing More Than Cancer

May 18, 2016
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by Jason M. Breslow Digital Editor

Each year, drug-resistant bacteria, or “superbugs” as they’re more commonly known, kill 700,000 people worldwide. By 2050, experts warn, that figure could reach as high as 10 million, more than cancer kills today.

With the global health risk expanding exponentially, a blue ribbon commission appointed by Prime Minister David Cameron of Britain released on Wednesday an action plan that it said was necessary in order to avoid “tragic human costs” in the future, as well as “very real economic” consequences.

The long-anticipated review details a threat that’s being compounded from multiple angles. Antibiotics are being overprescribed, the commission noted, and the more modern medicine makes use of antibiotics, the more germs become resistant to them. But the problem of overuse isn’t just confined to humans. Antibiotics are also being overused in animals that are raised for food, an issue the review called “a significant concern for human health.” On top of all that, there’s no pipeline of new medications to replace those that have grown increasingly ineffective against stronger, more virulent strains of bacteria.

The plan spells out four key recommendations.

Step one should be a global public awareness campaign, followed by a renewed emphasis on solving the pipeline problem. Echoing a January call from big pharma seeking increased incentives for development, the commission proposed a program of “market entry rewards,” of around $1 billion each for the developers of successful new drugs. Antibiotics aren’t easy drugs to make money off of, and as the commission notes, between 2003 and 2013, only $1.8 billion of the $38 billion in venture capital investment in pharmaceuticals went towards antibiotics.

Reducing the unnecessary use of antibiotics should be a third area of focus, according to the commission. Earlier this month, a study from the Centers for Disease Control and Prevention and the Pew Charitable Trusts found that in the United States alone, 30 percent of antibiotics prescribed in doctors’ offices, emergency rooms and hospital-based clinics are not needed.

The commission said overprescribing can be addressed, in part, through rapid diagnostic testing. It noted that in most countries, doctors “still prescribe important medicines like antibiotics based only on their immediate assessment of a patient’s symptoms, just like when antibiotics first entered common use in the 1950s.”

The commission also called for reducing the unnecessary use of antibiotics in agriculture — particularly when it comes to drugs that are medically important for humans. In the U.S., for example, more than 70 percent of antibiotics deemed medically important for people by the Food and Drug Administration are sold for use in animals. In some cases, these drugs are used to treat sick animals, but often they are used to promote growth, allowing farmers to raise larger animals on less feed.

Action won’t be cheap. The commission put the cost of its plan at $40 billion over 10 years. It proposed several ways to pay for that: from implementing a tax on antibiotics to allocating a share of G20 nations’ existing healthcare spending toward tackling antibiotic resistance.

In a conference call with reporters on Wednesday, the commission’s chair, Lord Jim O’Neill, said, “Indeed, when you think of that potential cost, $40 billion over 10 years should very definitely be regarded as a pretty cheap investment rather than a cost in terms of ensuring a whole number of things.”

The cost of inaction in terms of lost global production, the commission warned, could reach as high as $100 trillion by 2050 — to say nothing of the millions of lives that could also be lost.

“Even at the current rates,” O’Neill wrote in the review, “it is fair to assume that over 1 million people will have died from AMR [antimicrobial resistance] since I started this review in the summer of 2014.”

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