|Tackling antimicrobial resistance: From science to pharmaceuticals policy|
Antimicrobial resistance (AMR) is a global, multidimensional phenomenon occurring in humans, animals, and environmental ecosystems. It is the ability of microbes, e.g. bacteria, viruses, fungi and protozoa, to survive in the presence of medicines designed to kill or inactivate them (antimicrobials: antibiotics, antivirals, antifungals and antiprotozoals). At patient level, AMR hampers the effective treatment of microbial infections, leading to prolonged, severe disease and, in some cases, death. At community level, it amplifies the risk of infection outbreaks, epidemics and pandemics. AMR is a growing problem, predicted to cause millions of deaths worldwide in the coming decades. The research and development pipeline for new antimicrobials has dried up, partly because of an oligopolistic market structure in a research area considered to give a low return on investment. Concerted EU and Member State action has led to an overall decrease in antimicrobial consumption; however, the relative use of both broad-spectrum and last-resort antimicrobials continues to grow. The lack of investment in prevention, diagnostics and adequate healthcare infrastructure is further driving the preventive prescription of antimicrobials. Under-investment in good-quality healthcare is one of the main drivers of AMR. Tackling the socioeconomic determinants of health – such as reducing overall poverty and economic inequality, ensuring basic standards of living, education, and health – is imperative to reduce the burden of infection and the spread of AMR. Addressing the causes of AMR requires a multidisciplinary and multisectoral approach, involving not only the health sector but also other sectors, such as agriculture, environment and trade. The forthcoming revision of the pharmaceuticals package will be a chance for the EU to drive forward policies to ensure equitable access to safe, effective and affordable pharmaceuticals for unmet medical needs, and to define strategies for incentives to promote research into innovative antimicrobials.