Antimicrobial resistance is a complex issue.
The series of five papers looks comprehensively at how antimicrobial resistance is being tackled worldwide and outlines future priorities for researchers and policymakers.
The study was led by Prof. John-Arne Røttingen - executive director of Environmental Health and Infectious Disease Control at the Norwegian Institute of Public Health and adjunct professor of Global Health and Population at Harvard University - and involves a number of international experts.
It says that current global efforts to combat resistance are "too modest" and "poorly coordinated," and calls for renewed focus on finding effective policies to combat antimicrobial resistance. It also points out that globally, lack of access to antimicrobial drugs remains a major issue.
Access should not be denied to those in need
Efforts are being made to curb unnecessary antibiotic use in cases where they are not medically needed, particularly in agriculture and richer countries, where they are over-prescribed.
Meanwhile, necessary medicines still remain inaccessible for thousands of people in parts of the world, particularly babies, children and mothers, who are still at risk of serious illness or death from treatable infectious diseases.
Globally, more people still die annually from a lack of access to antimicrobials than they do from being infected by resistant bacteria.
Efforts to fight resistance must not inadvertently restrict access to antibiotics for those who need them, say the researchers, who insist that distribution must continue for those in need.
Lack of guidance to reduce antimicrobial resistance threat
The authors cite a lack of reliable guidance on how to control antimicrobial resistance. Current measures to curb usage, such as guidelines promoting responsible use of antibiotics in hospitals, or infection prevention measures, are poorly understood.
In many countries worldwide, it is not clear whether current policies will either work or provide value for money. Action is needed to fully evaluate and research the best ways to control the threat.
The authors stress that to overcome resistance, a global "One Health" approach is needed, which recognizes that the health of humans, animals and ecosystems are interconnected. Any policy to tackle resistance must address each of these areas.
They also call for stronger incentives for pharmaceutical companies to develop essential new antibiotics and a radical overhaul of the finance and development mechanisms for new drugs.
Prof. Røttingen says:
"At the moment, the economic value of new antimicrobial drugs doesn't materialize until the old drugs have failed, by which time it is too late. We need to completely rethink the way that research into antimicrobials is funded, starting by decoupling innovation in drug development from sales. The funding of these drugs needs to be driven by public health needs, not by profit."
He explains that the problem - which could persist for generations to come - and the complexity of responses needed are too big for the World Health Organization (WHO) alone to tackle.
To improve international collaboration on tackling the growing threat, the authors recommend forming a new UN-level coordinating body, or an international treaty to ensure that countries will implement the necessary policies.
Action is needed on three fronts simultaneously: extending access, conserving existing antimicrobials and ensuring innovation of new ones.
These three goals can only be met by integrated solutions, supported by concerted and coordinated global action from politicians, industry and individuals.
Co-author Prof. Alison Holmes, of Imperial College London, adds that there will be no single solution to the problem; it needs to be tackled synergistically, on multiple fronts, with "an unprecedented level of international cooperation."
In April of this year, Medical News Today reported that most countries have no national plan to tackle antimicrobial resistance.