Russia’s war in Ukraine is depleting resources to build a better health system, and Sino-US rivalry is undermining the global solidarity needed to deal with future pandemics. .
But drug-resistant ‘superbugs’ and massive underinvestment in new antibiotics to combat fragile primary care systems may be the number one enemy to global health.
This was by global health leaders who were discussing ways to attract better investment in health at an event hosted by the European Investment Bank (EIB) and the World Health Organization (WHO) on Monday.
One of the largest investments required is research and development (R&D) of new antibiotics in the face of increasing drug resistance. However, the sector attracts less than 5% of his venture capital investment in pharmaceutical R&D.
The main reason for this, according to Barbara Kerstiens, head of the European Commission’s Directorate General for Research and Innovation’s Disease Control Unit, is the “high risk of failure”.
“Under the Innovative Medicines Initiative, we have funded a large program to support the development of new antibiotics, but more than a decade later, nothing has materialized, and the risk remains. is just higher,” says Kerstiens.
The European Commission is working with the EIB to provide “push-and-pull incentives to stimulate the development of these new antimicrobials,” she added.
John Ryan, Acting Deputy Director General of the European Commission’s Office for Health and Food Safety, helped raise innovative funding to develop new antibiotics.
“this is [field] It doesn’t really fit the current model of big pharma doing this because it takes a very long time to realize a return on a very high investment,” said Ryan.
“We really need to think of alternative models and one of the things that I have been very impressed with in the last decade is the rise of product development partnerships focused on diseases for which there is no market. We can form partnerships that will facilitate the production of new treatments, while undermining them,” he said.
he gave the example of sleeping sickness medicine received approval Developed through such product development partnerships and approved by the U.S. Food and Drug Administration (FDA) in 2021
medicine, Fexinidazole was developed as part of an innovative partnership with the nonprofit research and development organization Drugs for Neglected Diseases. Initiative (DNDMe) and pharmaceutical company Sanofi.
“We have to think about how we involve models and pharmaceutical companies, but we don’t just rely on pharmaceutical companies,” said Ryan.
He also stressed the urgent need to ensure that countries put in place “better controls” over antibiotic use to slow the emergence of drug resistance.
“Currently, those facing these bigger problems tend to be the high-income countries that use antibiotics more intensively and use more recent antibiotics in much larger quantities.
“Like most living things, [pathogens] It’s very clever, very complex, and it pushes you to an evolutionary state of evading the tools in front of you,” Ryan said.
“Without antibiotics, we can’t have safe surgery, we can’t have safe births, we can’t prevent infection in people who need intensive care or who die after trauma or surgery. So we’re talking about modern medicine as a whole, which the world as a whole isn’t ready to invest in,” said Jeremy Farrar, director of the Wellcome Trust.
“The long-term nature of research and innovation should not be underestimated, and we must recognize that the private sector has an important role to play. If we need antibiotics to treat new infections, we need to understand that the public sector and charities will have to invest and pay for those products. maybe not.”
Farrar added that the world doesn’t appreciate antibiotics and vaccines enough.
“We used to think that antibiotics were as cheap as chips. Like Smarties, they are very cheap to buy in many parts of the world. I didn’t take care of them.
“If we lose this class of drugs, or if tuberculosis becomes more resistant, or indeed if malaria becomes more resistant, the pandemic of these diseases will grow and we will not really be able to fight it. You should be able to.”
Farrar also advocates for “a different model between the public and private sectors,” encouraging companies to develop these essential medicines for the future, thereby enabling more Easier to access.
Primary health as a foundation
WHO Director-General Dr Tedos Adhanom Ghebreyusus praised the EIB’s €500 million commitment to support primary health care in Sub-Saharan countries and called for investment in primary health care.
“Individuals, families, communities, economies and nations can thrive when health is protected and promoted. It’s about investing and reorienting the system,” said Tedros.
“More than 90% of essential services can be delivered through primary health care, including many that promote health, prevent disease, and avoid or delay the need for more costly secondary and tertiary care. increase.”
Meanwhile, EIB Vice President Thomas Estros warned that “the current geopolitical situation may further put a hold on long-term investments in health and life sciences.”
“The state budget is being stretched by the food and energy price shocks caused by Russia’s invasion of Ukraine,” Estros said. “Fiscal pressures are mounting, but long-term health care challenges remain. What is clear is that we must prioritize investments in health care before the next crisis hits.”
Helen Clark, former Prime Minister of New Zealand and co-chair of the Independent Panel for Pandemic Preparedness and Response, said: “We are more resilient and able to adjust quickly to deal with the crisis while maintaining all services. It is important to build a health care system in a certain country. Pandemic-resistant country.
“The World Bank’s new Pandemic Fund, in collaboration with the WHO, requires a minimum of $10.5 billion annually and invests primarily in protecting low- and middle-income countries. We have a commitment of just over a tenth of that. That’s not sustainable financing.”
Image credit: Flickr: Rumi Consultancy/World Bank.
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