Scientific Foresight (STOA) By / April 13, 2023

Towards a new EU pharmaceutical strategy: insights from the science and policy of antimicrobial resistance

Antimicrobial resistance (AMR) causes 33 000 deaths in Europe annually. The European Parliament’s Panel for the Future of Science and Technology (STOA) held a workshop to discuss scientific and policy breakthroughs to counter AMR on 29 March 2023.

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Written by Luisa Antunes.

Antimicrobial resistance (AMR) causes 33 000 deaths in Europe annually. The European Parliament’s Panel for the Future of Science and Technology (STOA) held a workshop to discuss scientific and policy breakthroughs to counter AMR on 29 March 2023. The lessons learned will serve Members of the European Parliament in the forthcoming discussions on the revised pharmaceuticals package.

The Chair, STOA panel member, Lina Galvez Munoz (S&D, Spain), appealed to the Commission and Member States to take action on this public health issue, which may increase 10‑fold by 2050, surpassing cancer as the second biggest cause of death worldwide.

The first session of the event focused on new insights from science, in particular from monitoring, new antimicrobial strategies and prevention, including vaccines.

Frank Aarestrup, Professor of Microbiology at Technical University of Denmark, introduced novel technologies such as metagenomics and wastewater sequencing for monitoring and surveillance of antimicrobial resistance genes. These technologies are applicable to any living being and habitat, making them an essential tool in modern global AMR surveillance. Data sharing and open science are important to accomplish this.

Francesco Imperi, Professor of Microbiology at University Roma Tre in Italy, presented possible alternatives to antibiotics. These include resistance breakers, antibiotic adjuvants, antivirulence drugs and phage therapy. Professor Imperi stressed the need to preserve existing antibiotics (stewardship) and to develop rapid diagnostic tools. It is still possible to identify novel antibiotics, by investigating yet-unexplored microbial bacterial diversity, which accounts for 99 % of existing microbes.

Pedro Madureira, co-founder and CSO at Immunethep in Portugal, presented a new immunotherapeutic strategy that can be used to help our immune system fight infections. This vaccine strategy neutralises a common bacterial molecule, GAPHD, that is present in the five bacterial groups that cause more than 80 % of global infections (Escherichia coli, Klebsiella pneumoniae, methicillin-resistant Staphylococcus aureus (MRSA), Streptococcus pneumoniae and Streptococcus agalactiae).

Session two focused on a discussion of policy strategies. Malin Grape, Swedish ambassador on AMR, presented the different EU and global level policy measures in place to counteract AMR. AMR will be a focal point of the upcoming revision of the pharmaceutical package, as well as of the Council’s recommendations on the implementation of the EU One Health action plan. It is essential to translate scientific evidence into implementable policy. The solution will be to ensure equitable access to a diversified pool of both new and old antimicrobials, which requires a discussion on models of financing.

Clare Chandler, medical anthropologist at the London School of Hygiene & Tropical Medicine in the United Kingdom, stressed that the development of new antibiotics is but a partial, temporary fix to a public health problem. A more sustainable solution is to reduce society’s infrastructural reliance on antibiotics and address systemic problems at the basis of AMR, such as healthcare, hygiene, productivity and inequality, by reinvesting in physical and economic structures, including good quality public healthcare, good working conditions, good nutrition, patient follow-up, and vaccination. More emphasis should go on policy research, which only accounts for 1 % of the total AMR funding.

A question and answer session followed, where speakers discussed topics including new approaches in artificial intelligence as opportunities for vaccine development, the importance of data sharing, the link between AMR and the environment, and the nature of incentives for the development of new antimicrobials.

The Chair concluded with a reflexion on how we do not need to socialise the cost and privatise the profits, but rather discuss money and benefit allocation, using a global approach focused on international collaboration and interdisciplinary science, for equitable, reliable access. The solution to AMR cannot be incentives for private industry alone – we should move towards a public ownership of research and development.

In conclusion, the workshop discussed the urgent need for a new EU pharmaceutical strategy to address AMR. The workshop provided insights into new scientific and policy breakthroughs, including alternatives to antibiotics, monitoring, surveillance, and policy strategies for equitable access to old and new antimicrobials.

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