This week a pledge by G7 leaders to address 'market failures' that discourage antibiotic R&D and encourage overpromotion won the support of the Association of the British Pharmaceutical Industry (ABPI).
The ABPI welcomed the “commitment for collaborative global action by the G7 on tackling the unique medical, scientific and economic challenges presented by antimicrobial resistance” telling us antibiotic stewardship was a core focus of the industry declaration launched at World Economic Forum meeting in Davos in January.
“The companies committed to encouraging better and more appropriate use of new and existing antibiotics, including through work that supports the antibiotic stewardship principles set out by the World Health Organization (WHO) Global Action Plan on antimicrobial resistance (AMR), and via improved education of clinicians.
The ABPI added that: “This support extends to promoting more judicious use of antibiotics in livestock, as part of a ‘one health’ approach.”
Exacerbating inappropriate use
But industry support for efforts to preserve antibiotics is disingenuous according to Gemma Buckland Merrett, senior research Manager at NGO Health Action International (HAI), who suggested current marketing practices are part of the problem.
“Evidence is starting to show that increased marketing of antibiotics by the pharmaceutical industry may be exacerbating inappropriate antibiotic use” Merrett told us.
“Despite the risks of resistance, pharmaceutical companies have continued to market antibiotics, often incentivising medical and veterinary personnel to overuse or inappropriately prescribe antibiotics.
Merrett cited studies conducted in India and China alongside earlier research to support her argument that pharmaceutical marketing practices - and the resulting overuse of antibiotics - have exacerbated the spread of bacterial resistance to antibiotics.
She added that: “To end this harmful practice, countries need regulatory controls that address prescription and marketing practices to ensure equitable, sustainable access and appropriate use of antibiotics.”
Sales incentive
Merrett’s suggestion is in keeping with observations outlined in the Review on Antimicrobial Resistance published in May last year.
According to the authors “Companies are incentivised to increase their sales, even if these extra sales have little or no medical value and come at the cost of adding to drug resistance.
“This leads to a large amount of over-use for antibiotics and is at odds with the objective to conserve antibiotics to make them last longer before resistance arises.
The ABPI rejected Merrett’s suggestion and said the drug industry is “at the forefront of leading action to address antimicrobial resistance including a commitment to encouraging better and more appropriate use of new and existing antibiotics.”