Pharma industry must act to fight drug resistance, says CGD
Report makes four recommendations to contain and reduce drug resistance
Efforts to improve the health of poor people in the developing world by increasing the availability of drugs to treat diseases such as malaria, HIV, and tuberculosis are accelerating drug resistance, which is raising costs and claiming lives, finds a report from the US Centre for Global Development (CGD).
‘Drug resistance is a natural occurrence, but careless practices in drug supply and use are hastening it unnecessarily,’ said Rachel Nugent, chair of the expert Working Group that prepared the report, The Race Against Drug Resistance.
Rich countries also suffer from resistance problems. Superbugs such as MRSA increased from around 2% to more than 50% of staph infections in many US hospitals between 1974 and 2004. More people in the US die each year from MRSA than HIV/AIDS, the report reveals.
In the developing world, millions of children die annually from drug resistant disease strains and since 2006 donors have spent more than US$1.5bn on advanced drugs to treat resistant diseases.
The report urges the World Health Organization (WHO) to reverse a decade of neglect of drug resistance and to take the lead in getting others involved. Action is needed from pharmaceutical companies, national governments, hospitals, healthcare providers, pharmacies, and even patients, it says.
In recent years governments and private investors have worked to increase access to drugs in developing countries, particularly for malaria, HIV, and tuberculosis. Access to anti-retroviral drugs for HIV/AIDS patients has risen more than 10-fold, deliveries of the most effective anti-malarial drugs has increased more than eight-fold, and access to TB drugs has grown dramatically, the report reveals.
According to CGD there is a strong link between the volume of drug use and emergence of drug resistance, particularly in settings with weak safeguards for appropriate use and monitoring of effectiveness. In countries where people consume the highest amounts of antibiotics, 75–90% of strep pneumoniae strains are already drug-resistant.
The report, released with a companion film, identifies the common drivers of resistance across diseases – a mix of technology gaps, behaviour that leads to inappropriate use of medicines, weak health systems, poor drug quality, and excessive use of antibiotics in agriculture.
Because so many forces are at work, the Working Group calls for collective action to fight drug resistance and makes four recommendations.
First, it recommends establishing a network of multi-disease surveillance laboratories to track the emergence and spread of resistant strains and quickly share the information.
Second, the pharmaceutical industry should set voluntary standards to maintain the quality of its products from manufacturing through final delivery to the patient.
Third, regulation should be strengthened with a consortium of donors partnering regional economic commissions to support new regional networks of national drug regulators and enhance existing ones to monitor drug quality and enforce laws.
Fourth, those who fund research should create a web-based marketplace for relevant research across diseases that would serve as an innovation showcase and provide technical assistance, connect researchers and match good ideas with investors.
‘We can no longer afford to be indifferent to the spread of drug-resistant diseases,’ said Rachel Nugent, who led the Working Group that prepared the report. ‘For the sake of all people who seek effective healthcare, now and in the future, drug resistance must be addressed urgently and aggressively as a global health priority.’