Two reports on the economics of AMR: UK Parliament, US National Academy of Science

Dear All: Two links to share today.

First, we have a report to the UK House of Commons by their Health and Social Care Committee. This is a well-written summary of the core problem, the economic challenge for pharma, and the varied issues around resistance in human health, animal health, and the environment. Relevant to this community, we read on page 23 that

  • We expect to see tangible and rapid progress in this area within six months.
  • Efforts to pilot the Government and industry’s current preferred option of an upfront payment scheme should not be delayed.
  • Both government and industry should invest in this scheme.
  • We recommend that other options to address market failure, including changes to patent law for antimicrobials and Lord O’Neill’s ‘play or pay’ proposals, should also be considered by Government.

Strong stuff, especially mention of a UK pilot for upfront payment for antibiotics — I look forward to seeing how this plays out. As I’ve noted previously, antibiotics are like fire extinguishers or other infrastructure … we use them everyday, even if they don’t get us wet. Another good parallel is life insurance. Do you have life insurance? Are you unhappy that it hasn’t paid off this year?

Second, we have publication of the proceedings from a 2018 National Academy of Sciences workshop entitled “Understanding the Economics of Antimicrobial Threats.” The key feature of this report is its focus on economics.

  • How can you limit spread of influenza? Try closing the schools, the sooner the better! (.pdf page 53, numbered page 32).
  • Which is bigger, Zika or Ebola? It’s Zika by a good margin: about 20-fold more cases during recent Public Health Emergency Periods and 2- to 6-fold in terms of short-term costs ($3b vs. $7-18b, .pdf pages 55-6, numbered pages 34-5).
  • How much did the US appropriate for the 2014-16 Ebola epidemic? $5.4b (.pdf page 90, numbered page 69).
  • How much will AMR cost if not controlled? By 2050, global GDP would be 1-4% less and “the costs associated with the high AMR scenario amount to $53.7 trillion in lost GDP, $14.3 trillion in lost exports, and $10.8 trillion in additional health expenditures, amounting to a total loss of $80 to $90 trillion.” This is very similar to the estimate in the the first (2014) paper from the UK AMR review. (.pdf page 72, numbered page 51).

Yow! It really is time for action! All best wishes, –jr

John H. Rex, MD | Chief Medical Officer, F2G Ltd. | Expert-in-Residence, Wellcome Trust. Follow me on Twitter: @JohnRex_NewAbx. See past newsletters and subscribe for the future: https://13.43.35.2/blog/

Upcoming meetings of interest to the AMR community:

  • 7-9 Nov 2018 (Seville, Spain): Better Methods for Clinical Studies in Infectious Diseases and Clinical Microbiology: A Hands-on Workshop
  • 8 Nov 2018 (Alderley Park, UK): Bionow’s 1-day Bioinfect conference
  • 12-18 Nov 2018 (everywhere): WHO (and US CDC) Antibiotic Awareness Week. Events now being planned … see the WHO and CDC links for ideas, fact sheets, and graphical materials.
  • 12-13 Nov 2018 (London): Joint SCI– and Royal Society of Chemistry-sponsored 2nd annual Symposium on Antimicrobial Discovery. Online materials here.
  • 13 Nov 2018 (London): All-Parties Parliamentary Working Group on AMR meeting. Online materials here
  • [NEW] 15-17 Nov 2018 (Santiago de Cali, Columbia): 16th Infocus Forum on Fungal Infection in Clinical Practice. Online materials here.
  • 16 Nov 2018 (Berlin): Max Planck Institute for Innovation and Competition is organizing a conference on life sciences and innovation. Online materials here.
  • 19-20 Nov 2018 (Accra, Ghana): Call to Action on Antimicrobial Resistance. Latest agenda here. To attend, contact AMRCalltoAction@wellcome.ac.uk.
  • 21 Nov 2018 (London): NICE- & APBI-sponsored masterclass: “Using non-randomised data to estimate treatment effects in NICE submissions”. Details here.
  • 29-30 Nov 2018 (Birmingham, UK): BSAC (British Society Antimicrobial Chemotherapy): Antibiotic Resistance Mechanisms Workshop for Researchers
  • [NEW LINK] 7 Dec 2018 (Boston, MA): BAARN, Boston Area Antimicrobial Resistance Network 2018 symposium, 8:30am to 7pm at The Starr Center (185 Cambridge Street, Boston, MA). This is an excellent networking opportunity, especially for those based in the Boston area. Register here.
  • 15 Jan 2018 (London): BSAC’s Antimicrobial Chemotherapy Conference 2019: “An ABC for everyone involved in developing new antimicrobials.” Details here.
  • 14-15 Mar 2019 (Berlin): BEAM– and ND4BB-ENABLE-sponsored Berlin Conference on Novel Antimicrobials and AMR Diagnostics. Details here.
  • 21-22 Mar 2019 (Birmingham, UK): BSAC Spring Conference.

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EPA (part 5): Interagency Framework on AMR Risks of Antibacterial and Antifungal Pesticides

This is the fifth of a 5-part newsletter series. There is an initial 27 Sep 2023 newsletter introducing the EPA concept note, a second (28 Sep 2023) newsletter that expands on the EPA concept note, a third (12 Jan 2024) newsletter about ending the use of streptomycin spray on citrus crops, and a 4th newsletter (27 Jan 2024) containing some additional resources. Dear All, Excitingly, the US EPA

HLM on AMR at UNGA: The end of the beginning

Aside: Please refer to our UNGA 2024 webpage for additional post-HLM notes and updates. Dear All (and with thanks to Damiano for co-authoring), Last week in NYC, the UN General Assembly (UNGA) and all its surrounding activities created a lot of energy (not to mention a giant traffic jam)! After a series of side meetings

Without action, AMR costs go from $66b to $159b/yr by 2050

Dear All, A new paper from Anthony McDonnell and a team led by the Center for Global Development extends estimates of the health-related impact of AMR (e.g., death) to a consideration of the economic ($) cost of AMR. To follow the plot, here are the links you will need: The new paper: “Forecasting the Fallout

UN TV: You can watch the AMR High-Level Meeting at UNGA

Dear All, The AMR HLM (High-Level Meeting) at the UN General Assembly starts at 10a ET today.  You can watch it here on UN TV: https://webtv.un.org/en/asset/k11/k11knc6w2t Addendum: It’s available for replay at that same link. See also the 1 Oct 2024 newsletter for a review of the HLM. All best wishes, –jr John H. Rex, MD

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