To Push or To Pull? In a Post-COVID World, Supporting and Incentivizing Antimicrobial Drug Development Must Become a Governmental Priority.
To Push or To Pull? In a Post-COVID World, Supporting and Incentivizing Antimicrobial Drug Development Must Become a Governmental Priority.
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DOI：
10.1021/acsinfecdis.0c00681
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发表时间：
2021-08-13
影响因子：
5.3
通讯作者：
Ebata A
中科院分区：
文献类型：
--
作者：
Cama J;Leszczynski R;Tang PK;Khalid A;Lok V;Dowson CG;Ebata A
2019冠状病毒病大流行使全世界重新关注传染病对全球健康和对世界经济的影响方面的危险。即使在高收入国家，人们也发现卫生系统在应对这种新的传染性病原体方面存在不足。然而，致病细菌和真菌的抗微生物药物耐药性甚至更大的长期危险仍然没有得到充分认识，特别是在普通公众中。尽管抗菌药物开发面临着重大的科学挑战，但目前最严重的挑战似乎是经济方面的，缺乏可行的市场导致药物开发管道崩溃。因此，世界各国政府迫切需要进一步鼓励开发抗微生物药物。在过去十年中，大多数激励策略都集中在所谓的“推动”激励措施上，以弥补抗微生物药物研发的成本，但这些措施不足以恢复管道。在这一视角中，我们分析了目前抗菌药物开发的激励策略，并将重点放在“拉动”激励上，其目的是提高创收，从而解决抗菌药物市场失灵的挑战。我们在更广泛的“同一个健康”背景下进一步分析了这些激励措施，并强调制定和执行严格协议的重要性，以确保适当的生产实践和负责任的使用。我们的分析重申了国际合作、抗菌素研究协调以及持续供资对应对这一重大全球挑战的重要性。如果不能明智和持续地投资以激励抗菌素管道，将在未来几年对全球健康和福祉造成灾难性后果。
The COVID-19 pandemic has refocused attention worldwide on the dangers of infectious diseases, in terms of both global health and the effects on the world economy. Even in high income countries, health systems have been found wanting in dealing with the new infectious agent. However, the even greater long-term danger of antimicrobial resistance in pathogenic bacteria and fungi is still under-appreciated, especially among the general public. Although antimicrobial drug development faces significant scientific challenges, the gravest challenge at the moment appears to be economic, where the lack of a viable market has led to a collapse in drug development pipelines. There is therefore a critical need for governments across the world to further incentivize the development of antimicrobials. Most incentive strategies over the past decade have focused on so-called “push” incentives that bridge the costs of antimicrobial research and development, but these have been insufficient for reviving the pipeline. In this Perspective, we analyze the current incentive strategies in place for antimicrobial drug development, and focus on “pull” incentives, which instead aim to improve revenue generation and thereby resolve the antimicrobial market failure challenge. We further analyze these incentives in a broader “One Health” context and stress the importance of developing and enforcing strict protocols to ensure appropriate manufacturing practices and responsible use. Our analysis reiterates the importance of international cooperation, coordination across antimicrobial research, and sustained funding in tackling this significant global challenge. A failure to invest wisely and continuously to incentivize antimicrobial pipelines will have catastrophic consequences for global health and wellbeing in the years to come.
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