A new report by economist Jim O’Neill, chairman of the Review on Antimicrobial Resistance, sets out a plan to “overhaul the global antibiotics pipeline” over the next decade.

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O’Neill argues for a global “Innovation Fund” of $2 billion over 5 years to fund “blue-sky research” into drugs and diagnostics.

“No new classes of antibiotics have been created for decades and our current drugs are becoming less effective as resistance increases,” O’Neill explains, of the rationale behind the report.

“We need to kick-start drug development to make sure the world has the drugs it needs, to treat infections and to enable modern medicine and surgery to continue as we know it,” he continues. “My review on AMR [antimicrobial resistance] has today published clear proposals to supercharge antibiotics discovery, potentially saving millions of lives for a fraction of the $100 trillion cost of interaction.”

In his report, O’Neill makes three recommendations on how to address the shortfall in commercial investment in antibiotics.

The first of these recommendations is to support a viable market for high-priority antibiotics by committing lump-sum payments to successful drug developers. O’Neill argues for a global body that would make payments incentivizing the development of antibiotics to combat drug resistance.

The advantage of this approach, says O’Neill, is that it eases the pressure on drug companies to sell new antibiotics in large quantities. This large-scale distribution of antibiotics can contribute to the development and spread of drug resistance.

Secondly, O’Neill says that to “jump start” a new cycle of innovation in antibiotics, a global AMR “Innovation Fund” of $2 billion over 5 years would help more “blue-sky research” into drugs and diagnostics get off the ground.

Finally, the report suggests that partnerships between academia, industry and public bodies facilitating clinical trials could help “catalyze” antibiotic discovery by supporting the development process at all points of the research and development pipeline.

The kind of substantial revisions to the antibiotics pipeline called for by O’Neill could be funded by as little as $16 billion over 10 years, he claims – less than 10% of the current global market for antibiotics.

To put this expenditure into context, antibiotic resistance currently costs the US about $20 billion every year in excess health care costs.

Dr. Manica Balasegaram, of Médecins Sans Frontières’ Access Campaign, says that the report is timely and highlights major gaps in needs-driven research and development. Dr. Balasegaram suggests that “bold interventions such as de-linkage – a measure that uncouple profitability from volume of sales – are urgently needed in order to promote innovation, access and conservation of antimicrobials.”

GlaxoSmithKline’s President of Pharmaceuticals R&D Patrick Vallance also adds the pharma giant’s support to the report:

We are very encouraged by the ideas it sets out to modernize the economic model to encourage investment in research and ensure reasonable returns for successful innovation while discouraging unnecessary use of new antibiotics.”

The Review on Antimicrobial Resistance say they will spend the next year engaging with an international advisory group and governments and pharmaceutical companies around the world to further develop their proposals.

However, O’Neill emphasizes that the proposed pipeline revisions are just one part of the solution to AMR. The way that antibiotics are used both in humans and animals also needs to be addressed, the report reminds, and the overall environmental implications more carefully considered.

Last year, Medical News Today took an in-depth look into to what extent antibiotic resistance has become a global threat to public health.