Comment - Antibiotic Action

TRACEY GUISE & LAURA J.V. PIDDOCK

‘If health fails, all else fails’ said Margaret Chan, Director General of theWorld Health Organization (WHO), in her 62nd address to the Regional Committee for Europe in September 2012.

She had just spoken of the need to tackle the major health and social issues required to meet the WHO Millennium Development Goals leading to improved health for all by 2015. High on the list of stated priorities was the need to tackle the continued rise in antibiotic-resistant bacteria and the lack of development of new antibiotics.

Her words resonate loudly with Antibiotic Action, the UK-led global initiative that exists to inform and educate all about the need for discovery, research and development of new antibacterial drugs. Launched at the Houses of Parliament in November 2011, the initiative received unprecedented interest and support. Organisations across the globe sought to partner and support Antibiotic Action, manuscripts were accepted and published by esteemed international peer-reviewed journals, stories were written in newspapers and magazines and broadcast on radio and television. Antibiotic Action gained a respectable following on Twitter, an Early Day Motion was presented to the House of Commons and thousands of individuals signed the online petition. It was an explosive start to an initiative that began by examining why, after over a decade of esteemed publications, committees, reports and professional concern, they had failed to generate sufficient interest to prevent the rapid decline in antibacterial drug discovery research and development.

So almost 12 months on, what has Antibiotic Action achieved? Highlights include:

• Collaborations with international groups, including ReACT, the Infectious Diseases Society of America, Alliance for the Prudent Use of Antibiotics and L’Alliance (representing 27 EU nations).
• Meeting the Health Minister Simon Burns and civil servants in the Department of Health. We now provide briefing documents.
• Meeting the Shadow Health Minister Jamie Reed, and provision of questions for the Prime Minister to answer in the House of Commons.
• Provision of administrative support to establish the All Party Parliamentary Group on Antibiotic Discovery and Development.
• Providing the momentum to stimulate revision of the regulatory processes for licensing new antibiotics.
• Discussions with the WHO to help them deliver their action plan on antibiotic resistance – particularly in the area of public engagement.
• Facilitating public awareness and engagement by establishing an international network of Antibiotic Action Champions – some of whom have already successfully ‘flown the Antibiotic Action flag’ at student festivals and international conferences.
• Discussions with major funding bodies, such as the BBSRC, MRC and Wellcome Trust, on what can be learnt from industry to understand why some drug discovery programmes have not yielded new drugs.

The need for new antibiotics and the devastation the absence of antibiotics will wreak is undeniable. However, it will take time to alter perceptions about the urgent need to develop new antibiotics – that or a cataclysmic event to grow public understanding – just think of the furore if Prince Philip’s recent bladder infection had been caused by an antibiotic-resistant bacterium which proved untreatable. We need to change the perception that antibiotics have failed – they have not – they are one of the miracles of modern medicine and the reason why many of us have reached adulthood today and will reach the extremes of age. As there is no collective memory of the pre-antibiotic era, the public voice is small, unlike that for other diseases such as cancer that many people are afraid they will die from. Antibiotic Action seeks to raise the voice to a deafening level so that everyone is aware that antibiotics underpin much of modern medicine from trauma to transplant surgery to joint replacements, and that infections are commonplace in these settings; governments and policy-makers must sit up, take note and act.

It has been proposed by many that it is financial incentives that will tempt industry to re-enter/continue to discover, research and develop new antibacterials as drugs for patients, and the recent GAIN Act in the USA and the EU Innovative Medicines Initiative seek to do this. It has been suggested by some that neither of these will have much impact; however, it is impossible to determine what the outcome will be and it is almost certain that it will take many different strategies and funding streams to resolve the situation. In particular, as microbiologists we must fight for our discipline to be heard equally with others that have high profiles. To do this we must make sure that the fantastic advances being made in academia are publicised and that there are mechanisms to facilitate development into new drugs. Links between academia, SMEs and Pharma require strengthening and new funding routes. In this way we can ensure that we retain the existing expertise and attract the brightest young minds to our fields of research, to discover and develop antibacterial drugs of the future. Antibiotic Action will continue to stimulate activities across disciplines to ensure new effective treatments are available. After all, without antibiotics the health of nations will fail – a fitting adjunct to the quote by Margaret Chan.

TRACEY GUISE, CEO British Society for Antimicrobial Chemotherapy (BSAC) & LAURA J.V. PIDDOCK,
Professor of Microbiology, University of Birmingham, BSAC Chair in Public Engagement and Director of Antibiotic Action
(Email [email protected])

We continue to seek new Antibiotic Action Champions, the remit of whom is simple, to inform as many people as possible of the need to discover research and develop new antibacterial drugs. If you wish to be a Champion please see the website for the resources we provide http://bit.ly/SHK5TC or contact Laura Piddock.