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International Clinical Trials

Can You Resist?

Alexander Fleming – who is credited with creating the first antibiotic, penicillin, in 1928 – cautioned as long ago as 1945: “There is the danger that the ignorant man may easily underdose himself and by exposing his microbes to nonlethal quantities of the drug make them resistant.” The O’Neill Commission on anti-microbial resistance (AMR) reported in 2015 that if we fail to act on AMR, then an additional 10 million lives would be lost each year to drugresistant strains of certain bacterial infections by 2050, at a cost to the world economy of $100 trillion.

In September, 193 UN member states agreed to combat the proliferation of drug-resistant infections, currently estimated to kill more than 700,000 people each year. At the 68th World Health Assembly in May 2015, a global action plan to tackle AMR was endorsed. To achieve the aforementioned goal, it set out five strategic objectives:
  • To improve awareness and understanding of AMR
  • To strengthen knowledge through surveillance and research
  • To reduce the incidence of infection • To optimise the use of antimicrobial agents
  • To develop the economic case for sustainable investment that takes into account the needs of all countries, and increase investment in new medicines, diagnostic tools, vaccines and other interventions
By contrast, an analysis released in November last year by the Tufts Centre for the Study of Drug Development estimated the average cost to produce a medication as about $2.6 billion, taking 10-15 years to accomplish. As I have previously remarked, there is little incentive for businesses to develop new antibiotics, since their use will be restricted so that resistance will not be built up. As an example, by 2013, the number of international pharmaceutical companies developing antibiotics had dwindled to just four.

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Graham Hughes
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