February 19, 2010
15 February – 5 March 2010
The Geneva Health Forum, created by Geneva University Hospitals and the Faculty of Medicine of the University of Geneva, would like to invite you to join an online discussion “Antimicrobial resistance: should the development of new antibiotics be a public health priority?” which is ongoing through 5 March 2010. This discussion will be followed by a session at the Geneva Health Forum conference from 19 to 21 April 2010.
The argument that GHF has put forth to launch the discussion is that “there are basically two approaches in the current literature on how to tackle the complex issue of antimicrobial resistance. One argues that relying on the development of new drugs to overcome resistance represents the main solution, while the other focuses on containment strategies to limit the misuse and abuse of antimicrobial drugs.” Read more background here.
To join the discussion, please click here.
What follows are highlights of key discussion excerpts to date:
Andreas Heddini, ReAct, Sweden:
- “When stating that the public sector should consider supporting R&D for new antibiotics and related health technologies, this does not mean business as usual. A completely new business model is called for, where the value chain in drug development is re-engineered to harness the capacity of both the private and public sectors and to ensure that any forthcoming products are made available to those who need them in all parts of the world.”
- “It is absolutely essential to avoid polarized stand points favoring one single option as the preferred solution as the problem of antibiotic resistance necessitates a broader approach in order to be managed. During the last year, there have been many developments in this area, notably by the EU-US Task Force, IDSA, BSAC, RFF, APUA, ReAct, and a number of other initiatives and we cannot afford to miss the opportunity. We are facing a global problem that requires joint action by all concerned actors.”
Stephan Harbarth, Geneva University Hospitals, Switzerland:
- “The recurrent shortage of ‘outdated’, narrow-spectrum antibiotics, the astonishing lack of rapid point-of-care diagnostic tests and the permanent underfunding of infection prevention initiatives perfectly illustrate how the current wisdom of the political and economic arena places the importance of market forces and financial incentives far above public health needs and preventive measures to combat antibiotic misuse and resistance. Thus, we need to be much more critical of the ongoing plea for development of new antibiotics if we are to find more sustainable solutions to the problems of multi-resistant microorganisms in this millennium”
- "The development of new antibiotics without having mechanisms to insure their appropriate use is much like supplying your alcoholic patients with a finer brandy." (Dennis Maki, IDSA meeting, 1998)
Douglas W. MacPherson, McMaster University, Canada:
- “While the globalization of risk in health is gaining appreciation, I would appreciate hearing some discussion that discriminates the traditional roles of international public health (control and mitigation) from health services delivery (disease management: diagnostics and treatment) in an integrated systems perspective. While the goals of one may be complementary to the other, is it possible that there may be challenges between these two disparate parts of global health that make antimicrobial drug resistance an issue of risk management.”
- “I would pose another perspective for discussion: if antimicrobial drug resistance is a problem beyond human health or public health that encompasses animal and botanical (agricultural and wild environments), how can other sectors be engaged in addressing the human role in risk managing this issue?”
Carlos F. Amábile-Cuevas, Fundación Lusara, Mexico:
- “To attempt to answer the question “do we need new antibiotics?, it may be necessary to disassemble and analyze the question itself. Who are “we”? What does it means to “need”? What would we consider “new antibiotics”? Before analyzing these one by one, both papers coincide (Stephan Harbarth and Andreas Heddini), and I with them, in the need for a much better strategy for using existing and upcoming (if any) antibiotics both, in clinical and non-clinical settings, which include better medical education, improved diagnostics for infectious diseases, and perhaps even regulation of the many issues surrounding antibiotic usage.”
Rachel Nugent, CGD:
- “… in the idea I posed in my earlier attachment for a drug resistance research and development platform, I argue that both researchers and potential funders and product developers have an incentive to use it to share ideas, develop collaborations, and otherwise speed the process of R&D. If true, the result could be to encourage new discovery and product development of the type we need.”