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The fight against superbugs dominated public health this week, with the publication of three separate reports on the battle against antimicrobial resistance.
The timing is not coincidental — this is the second anniversary of the Davos Declaration on Combating Antimicrobial Resistance, in which pharma companies pledged to develop much-needed new medicines while curbing the overuse that stimulates drug-resistant pathogens.
First to report was the industry itself. The AMR Alliance, a global coalition of pharma, biotech, generics and diagnostics groups, aggregated data from 36 companies which showed a total investment of at least $2bn in 2016 on AMR-related products.
Then came an independent report by the Access to Medicine Foundation, which benchmarked the 30 most active companies according to three criteria: R&D for new drugs; providing good patient access while guarding against overuse; and limiting the release of antibiotics into the environment. Clear winner in this AMR Benchmark report was GlaxoSmithKline, with Johnson & Johnson in second place. Entasis of the US leads the ranking of smaller biotechs. Altogether the 30 companies have 147 antibiotics in their R&D pipeline.
The third report was rather different. Stemming from Drive-AB, a project funded by the EU which looked at ways to invigorate development, it concluded that a $1bn “market entry reward” for an innovative, safe and effective new product could be the incentive the industry needs.
The prize, funded by governments and paid in annual instalments of $200m over five years, would quadruple the number of new antibiotics approved for sale over the next 30 years.
Why are you launching this partnership?
Over the past decades we have worked very hard to reduce the burden of leprosy, but have realised that the number of new diagnoses is still 200,000-250,000 a year and plateauing. We need to change our approach. Only using treatment will not work and we need to focus on how to interrupt transmission. If we put our resources together behind the same agenda, we can address the priorities.
What are the key elements of the new approach?
We need early diagnosis and prompt treatment. We have validated a digital tool in the Philippines for remote community workers which really accelerates the time for diagnosis and we are working on a state of the art diagnostic. We need proper mapping of where the disease is concentrated. We have shown that you can use contact tracing and offer drugs prophylactically to family, friends and neighbours [of those infected] to curb incidence. We need to increase advocacy and strengthen national programmes.
How quickly could the world reach “zero leprosy”?
Since 2000, funding has been drastically reduced after the World Health Organization declared it was eliminated as a public health problem. There was a big decline in attention which we aim to increase again. I’m very optimistic, given the new tools and if we manage to combine forces, but this is going to take a while. Leprosy is a disease that can take years to develop and even if there are no new diagnoses, we would have to wait 20 years to see the results.
Drugmakers 'flush with cash' Almost $30bn of healthcare acquisitions have been announced so far in January — the strongest start to a year in more than a decade, thanks to US tax reforms and companies' drive to replace successful medicines as they lose patent protection. Some fear an excess of exuberance. (FT)
Fear over CDC cuts Funding difficulties could mean the US Centers for Disease Control and Protection scaling back its work to ten priority countries from the 49 where it currently operates. Melinda Gates hit out at US cuts to foreign aid. (WSJ, FT)
WHO priorities World Health Organization chief Tedros Adhanom laid out his priorities for 2018, calling on all 192 member countries to adopt universal health coverage and help set up a global "health reserve army" for emergencies. (WHO)
Yemen misery mounts Already suffering from a million cases of cholera, conflict-stricken Yemen now faces the worst child diphtheria outbreak for a generation and rising instances of malaria. The UN said 22.2m people now needed humanitarian assistance. (Al Jazeera, Reuters, UN)
HIV and Her The Global Fund to Fight Aids, Tuberculosis and Malaria is linking with the private sector to launch Her — HIV Epidemic Response — targeting women and girls in Africa with a high risk of HIV. In some countries, girls account for more than 80 per cent of new adolescent infections. (Global Fund)
Obesity and development Health workers in the Amazon— one of the world’s most obese areas — believe there is a connection between obesity and brain development. UK paediatricians warned obese schoolchildren would remain dangerously overweight for the rest of their lives and called for action on junk food consumption. (FT, Telegraph)
Measuring burns The WHO launched the first Global Burns Registry, enabling standardised data collection from victims. There are 180,000 deaths each year from burn-related incidents, mostly in poorer countries. (Daily Star Bangladesh)
US health chief confirmed Alex Azar was confirmed by the Senate as health and human services secretary. The former pharma executive's priorities include reining in drug prices and mending fences with Congress after the rancour of the Obamacare repeal process. (Politico)
Tobacco troubles US regulatory advisers dismissed claims from tobacco giant PMI that IQOS, its new nicotine delivery system, was safer than cigarettes. The biggest study yet of the effects of ecigarettes from the US National Academies said they could lead to addiction and act as a gateway to tobacco, while Davos delegates were reminded that anti-smoking progress was slowing. (CNBC, NYT, FDA)
Mental health and human rights The first controlled trial of drug treatment among shackled people with mental problems in west Africa — " the most trapped, forgotten people on earth" — showed mixed results: day-to-day symptoms were blunted — but subjects were still held in chains. (NYT)
US lobbyists in overdrive The two big drug company lobbyists in the US set a new spending record in 2017. The Pharmaceutical Research and Manufacturers of America and the Biotechnology Innovation Organization together spent $35m lobbying the federal government. (Stat)
UK biotechs buoyant An industry report said UK biotech's pipelines were the biggest in Europe as it strives to become the third biggest hub behind San Francisco and Boston. Initial public offerings raised double the amount of the previous year. (City AM)
Prescription addiction The UK launched a review into prescription drug addiction. Bill de Blasio, New York mayor, is suing drug companies over the opioid crisis: "It's time for Big Pharma to pay for what they've done". President Trump's opioids commission has been called "a sham — by one of its own members. (BBC, NYT, CNN)
Digital health trends Health IT funding hit a record in 2017, spearhead by investment in artificial intelligence and analytics. Apple's health ambitions were underlined by its move to allow users to access medical records on their iPhones, raising privacy concerns. (Healthcare IT News, Washington Post, Mashable)
Padman to the rescue A new Bollywood film is challenging stigmas around periods in India. Padman tells the story of how Arunachalam Muruganantham, India's “menstrual man", invented a new way to produce cheap sanitary pads, improving menstrual health and providing an income for rural women. (The Conversation)
Best from the Journals
Pepfar and Aids Few public health programmes have been effective as George W Bush's "President’s Emergency Plan for Aids Relief". Since 2003, Pepfar has provided 13.3m HIV-infected people with antiretroviral therapy and provided care for more than 6.4m orphans and vulnerable children. (NEJM)
African hospital access The first full inventory of hospital access in Africa showed 29% of the population and about 28% of women of child-bearing age had difficulty accessing emergency treatment and lived more than two hours from the nearest public hospital. (The Lancet)
Alcohol and health Sugar tax on soft drinks might have the unintended effect of driving up alcohol consumption. Almost half of UK children have tried alcohol by the age of 14, a government study says, while a report argues there is no evidence that giving teenagers early access to alcohol has a positive effect. (BMJ, Guardian, Lancet)
Trust in trials The first assessment of redactions by industry sponsors of drug trial protocols says mistrust in such trials "can only change if the industry offers unconditional access to its protocols and other relevant documents and data". (Journal of Royal Society of Medicine).
Podcast of the week
Dealing with disaster The BMJ talks toVirginia Murray of Public Health England who helped put together the international agreement which aims to move the world away from reacting to disasters to preventing them. (BMJ Talk Medicine, 25m)
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Booze battle In a week full of warnings about the dangers of tobacco and alcohol, is it time to mimic cigarette-style health warnings on drinks? The Royal Society for Public Health is sparring with industry about how much detail should be on labels. Sensible public health measure or nanny-state intervention? Share your thoughts below or on our Facebook page, on Twitter @FT_Health, or email us via firstname.lastname@example.org
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