E-DRUG: Are you ready for a world without antibiotics? (2)
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Good article but short on realpoliick of this issue.
At the various WHO meetings recently it was the rich countries that 1)
limited the language on resolutions on Rational Use of Medicines, 2)
helped ensure that the programme is poorly funded.
Whenever the issue is raised at WHO governing bodies the EU raises
concerns but then seems to back down. The US insists that
practitioners should have the 'full portfolio' of drugs available to
them and for practitioners to make the decisions (let us forget the
freebies BigPharma gives to health profs, the 'bias' of professors
even in large US universities who were 'disciplined' at the instance
of students not faculty!).
Of course, while not wanting to loose the 'marketing' battle that
allows the rich countries to do what is foul in the guise of what is
fair: one of the proposed resolutions on Rational Use and AMR were
sought to be deflected by the rich countries with a resolution on
'Better medicines for children' - and who can be opposed to that? The
resolutions ended up being a hotch potch, and even so the programme
was starved of funds.
Evidence is a hostage of dealmaking in health! Institutionally the WHO
and its coterie of 'medical' professionals could be much more
assertive about these issues. There is room to be more that witnesses
to the potential disaster unfolding.
While a lot of work can be done at the national level (like Australia
does) there is a need for more consensus on Rational Use of Medicines
and Antimicrobial Resistance at the international level.
Another point is that since antibiotics speed up the growth of animals
for food, this is likely to be a huge fight. The food industry is
notoriously competitive. Should there be any reason why Europe cannot
export its ban on antibiotics in some animals to developing countries?
Surely this could contribute somewhat?
Even 'new' antibiotics are being prescribed casually, from my
anecdotal evidence. This would be interesting to look at.
And looking at the issue of AMR and innovation, there has been lots of
evergreening of patents (based on different dosages and combinations)
and increased costs, while research into this critical area is
pursuing but not at the pace that may be necessary. In fact Big Pharma
has duped rich countries into thinking that evergreening is necessary
for innovation when this article shows that very little is being done.
If BigPharma and others are making money from recycling old stuff and
continue to make money what is the incentive to undertake R&D? If the
current innovation is so good, then why is there so much calling of
attention to the lack of research (one could be mistaken this was a
neglected disease affecting only poor countries, which as we know for
decades of the 90/10 gap is acceptable)?
It is a pity that evidence based science is such a hostage to powerful
countries that put profits before health. Perhaps there is a
never-endig technological frontier that is cause for such CONTINUED
blind optimism in the 'market' of Intellectual Property and
oligopolistic R&D corporates.
Dr. Holloway who tried for many years to work within the WHO system
has now left Geneva. I recall at times how little resources they had
to do any work. Tough issue in what seemed to be a very hostile
environment, and overall she did well.
Nice stat she used to quote: Over 50% of antibiotics in the North are
irrationally prescribed (and these are 'good' health systems)!
Perhaps subprime-type issues in the North are not only limited to the
financial sector...
[Scandinavian countries, being very restrictive on antibiotic use and therefore having few problems with resistance unless patients come from more liberal countries carrying difficult microbes, struggle to get acceptance within EU for keeping a restrictive policy, i.e. put restrictions on new antibiotics and keep all antibiotics on prescription. Even countries in Europe sell antibiotics without prescription. The same restrictive use applies to use in animals. There you fight not only the BigPharma but also veterinarians who are allowed to prescribe and sell. Moderator]
Riaz
SEATINI South Africa
riaz.tayob@gmail.com