AMR - HealthCare Need and Impact
Antimicrobial resistance (AMR) is a natural phenomenon whereby bacteria become resistant to antibiotics. AMR doesn't directly kill; it makes the primary infection harder or impossible to treat. While the death toll from COVID-19 continues to rise, globally each year 700,000 people are dying from AMR (AMR Action Fund). Some scenarios estimate that by 2050 AMR could be claiming 10 million lives per year. Without global, harmonised and immediate action, the world is potentially heading towards a post-antibiotic era where common infections could once again kill.
With shrinking private investment over the past decade due to some downstream market failures for new small molecule antibiotics, few novel treatment modalities that circumvent pre- existing AMR mechanisms are in clinical development (Pew Charitable Trusts). There has been a discovery void for new antibiotics for the treatment of Gram-negative infections, especially those caused by the six "ESKAPE" pathogens. Whilst a total of 51 antibiotics were in the clinical pipeline as of December 2019, 75% were modifications of existing antibiotic classes and will only provide short term solutions.
The challenge of dealing with AMR is significant and a lack of novel treatment options for infections e.g. urinary tract infections (UTI) can cause life-time morbidity or even death. UTI's have an infection prevalence ranging from 12.9% (USA) and 19.6% (Europe), to up to 24% in developing countries (Medina & Castillo-Pino, 2019). UK incidence of UTI is highest in young women (NICE), with around 10-20% experiencing a symptomatic UTI at some time.
In 2015, the WHO adopted a global action plan addressing antimicrobial resistance and in 2016 passed a political declaration at the UN General Assembly. In July 2020, global pharma companies launched the AMR Action Fund. In the UK, infectious diseases account for 7% of deaths with annual costs of £30 Billion, (Parliament PostNote 2017). In the USA the cost is around $1.6 Billion for UTI infections alone. A 2018 English ESPAUR report highlighted a 35% increase in total infections resistant to key antibiotics from 12,250 in 2013 to 16,504 in 2017.