Conference Presentation, Panel
Superbugs: Avoiding an Existential Threat to Humanity
Milken InstituteEsther Krofah, Valeria Bortolaia, Ron Daniels, Peter Jackson, Peter Piot, Lance Price, Sneha Kemka
- Global deaths from drug-resistant infections are projected to reach 10 million by 2050, potentially wiping out $100 trillion from the global economy and causing the current annual toll of 700,000 deaths to escalate significantly.
- Without intervention, sepsis episodes could lead to 20 to 30 million deaths annually by 2050, becoming a primary driver of global population decline.
- Routine medical procedures, including surgeries and cancer therapies, are predicted to become increasingly difficult or impossible to perform due to the escalation of untreatable infections.
- The current pipeline for new therapeutics is critically depleted, with fewer than 150 people active worldwide in AMR drug development, no large pharmaceutical R&D currently in the UK, and no new products in the pipeline for many resistant microbial profiles.
- Short-term mitigation is expected from combination products and mechanisms, but these may only secure the sector for the next three to five years.
- The UK plans to announce a trial of a new "pull mechanism" incentive for antibiotics in the first half of 2019, with international expectation that this trial will set a precedent for global reimbursement reform.
- The UK aims to treble the number of Small and Medium-sized Enterprises (SMEs) involved in AMR solutions, with half of this growth derived from translating university science into biotechs and the other half from inward investment.
- Current antibiotic shortages, including 150 notified shortages in the US market recently, are attributed to manufacturers closing plants due to thin margins and reduced prescribing volumes.
- Denmark's 20-year ban on antibiotic growth promoters in livestock demonstrated a reduction of bacteria in chicken products from 80% to undetectable levels, supporting a strategy where animal waste and usage are regulated to prevent environmental contamination.
- Multi-drug resistant tuberculosis currently kills over a million people annually, with 500,000 suffering cases concentrated in Eastern Europe, China, India, and sub-Saharan Africa.
- Misuse of antibiotics is prevalent in low- and middle-income countries due to unregulated over-the-counter sales, while the overuse of colistin in chickens risks the emergence of truly untreatable organisms.
- The UK's Longitude Prize initiative seeks to develop point-of-care diagnostics to distinguish between bacterial and viral infections, aiming to reduce unnecessary prescribing.
- Precision medicine and data interoperability are identified as critical for determining the correct antibiotic for the right patient, requiring investment in biomarker identification and the application of machine learning to sepsis patterns.
- Commissioning incentives in England successfully increased early antimicrobial delivery rates from approximately 30% to over 80% while simultaneously reducing per capita total antimicrobial consumption.
- Retailers refusing to accept poultry treated with antimicrobials are highlighted as a significant driver for change, though labels claiming "antibiotic-free" may be misleading if they do not address the prevalence of resistant bacteria.
- Future infection control strategies envision General Practitioners utilizing mathematically modeled algorithms to determine the necessity of antimicrobial prescriptions.
- Populist pressures and a lack of sustained momentum could jeopardize resolutions, necessitating global collaboration to ensure new drugs are developed and then preserved rather than immediately overused.