Resistant pathogens - a catastrophe with advance notification

KfW and the German Healthcare Partnership host a conference on antimicrobial resistance

Schnell wraps up the conference

All over the globe resistance to common drugs is on the increase, posing particular challenges for low income countries. The fact that more and more microbial organisms, such us bacteria and fungi, have become resistant against drug treatment has turned into a major threat to global health. How to deal with this creeping challenge was the central question of an event organised by the German Healthcare Partnership (GHP) and KfW Entwicklungsbank in Berlin entitled "Antimicrobial Resistance (AMR) - Catastrophe with Advance Notification".

Every year, an estimated 700,000 people worldwide die unnecessarily due to AMR. The large majority of these deaths is a consequence of the growing resistance against antibiotics caused by the uncontrolled and excessive use of them in medicine, agriculture and in water cultures. The more humans and animals (and - through them - pathogens) are exposed to antibiotics, the more likely they are to develop resistances against them. This, in turn, makes it more difficult to use antibiotics to combat diseases. Worryingly, this does not only apply to mundane infections but also to serious ones such as tuberculosis, which - having almost been eradicated - has now reemerged as one of the deadliest infectious diseases.

A development issue that KfW wants to tackle

Resistant pathogens are a major public health problem in poorer and richer countries alike, and they do not stop at borders. But health systems in low income countries are often not robust enough to protect and treat people adequately against them.

"This is why AMR has now become an issue for development policy," said KfW Board Member Dr. Joachim Nagel at the opening of the conference on November 26th at the dbb forum Berlin, which was attended by over 100 guests from politics, academia, non-governmental organisations and the private sector. Nagel continued that the Ebola crisis in West Africa had clearly demonstrated what could be at stake in the case of uncontrolled diseases. The economies of the three affected countries Guinea, Liberia and Sierra Leone lost an estimated 50 billion dollars, in addition to thousands of lives.

Serious economic consequences

Dr Maria Flachsbarth, Parliamentary State Secretary, BMZ

In her keynote address BMZ Parliamentary State Secretary, Dr Maria Flachsbarth, underlined the stakes were high, pointing out that “antimicrobial resistance undermines the efficacy of established standard therapies and this leads to considerable increases in treatment costs.”

Roland Göhde from the GHP echoed her concern about the negative economic impacts of AMR and Dr Tim Eckmanns of the Robert Koch Institute quoted estimates according to which, by 2050, the AMR-related losses would add up to those incurred during the financial crisis of 2008.

In the ensuing panel discussion, in which six experts from public and private sector took part, there was agreement that great efforts still had to be made to bring the problem under control. Public awareness that a catastrophe is slowly "rolling towards us" and both prevention and mitigation measures are still insufficient. As a priority, the way antibiotics are prescribed or self-administered needs to be addressed, including through more comprehensive regulation.

Panelists also pointed out that the international surveillance of AMR had to be improved and that many countries’ laboratory capacities – both at the basic and the highly specialised levels - had to be strengthened, which calls for development financing.

More research and private sector investments needed

In addition to high-tech measures, even small changes can make a big contribution. A representative of "Doctors Without Borders" pointed out that simple hand washing and use of disinfectant significantly reduces the risk of infection with (multi-resistant) germs. Inadequate sanitary facilities, however, and the high prices charged for disinfectants in low income countries often stand in the way of this.

More incentives for innovation and investment in research were also called for, last not least because new antibiotics would also be needed. In order to achieve all of this, panelists agreed that it was time for all actors in the health sector – and particularly the private sector – to join forces so as to still change the course of this ‘catastrophe with advance notification’.

Friederike Bauer
December 2018

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