PRE-EMPTING AMR IN ASIA
Drug-resistant infections or more precisely, antimicrobial resistance (AMR) is recognised globally as a complex problem with serious consequences. Its impact on the healthcare sector and the economy is visible, worldwide. A report by the Inter Agency Coordination Group (IACG) on AMR has pointed out that alarming levels of resistance have been reported in countries of all income levels rendering common diseases untreatable and life-saving medical procedures riskier.
In the last one and half year, anti COVID-19 treatments contributed further to the already existing serious problem, as AMR was a major fallout of the battle against the pandemic stemming from antibiotics overuse.
The World Health Organisation (WHO) has already warned several times over the growing number of infections becoming harder to treat due to the plummeting efficacy of antibiotics. It has declared AMR one of the top 10 global public health threats facing humanity. We have addressed this serious concern earlier as well considering its enormity.
On a positive note, the Asian Clinical Research Network (ACRN) is being established now to conduct antimicrobial clinical research to develop the most effective ways to treat and prevent life-threatening drug-resistant infections. The Wellcome Trust is helping to establish the network by providing a large grant to National University of Singapore (NUS). Similar networks were set up in Europe, the US and Australia. This will be the first clinical trial network in Asia for drug-resistant infections.
NUS’s Saw Swee Hock School of Public Health will be hosting the network and it will work with local partners, the NUS Yong Loo Lin School of Medicine, Duke-NUS Medical School, Lee Kong Chian School of Medicine in Nanyang Technological University, Singapore Clinical Research Institute, and National Centre for Infectious Diseases. These organisations have also committed funding for the project.
This Asia level multi institutional and international collaboration is expected to strengthen and build research capabilities. This move is imperative as new antibiotics and improved ways of treating people are required. It is a deviation from the current model of clinical research in AMR, which funds individual clinical trials on an ad-hoc basis. It was found by the experts to be inefficient, both scientifically and financially.
Experts are of the opinion that AMR requires a multi-sectoral approach. In the World Health Assembly, 2015, countries were committed to the framework set out in the Global Action Plan (GAP) 2015 on AMR, which included development and implementation of multi-sectoral national action plans.
Eliminating AMR is assuming a lot of importance considering its spread and impact. Experts estimate that resistant bacteria could double the chances of developing a serious health issue and triple the chances of death. Already, at least 700,000 people die each year due to drug-resistant infections. A study ‘AMR: Implications and Costs’ published in 2020 has quoted a United Nations (UN) report showing that the mortality rate by 2050 caused by AMR will be 10 million, higher than caused by any other single disease. Region wise, the highest mortality rate of 4.7 million will be in Asia alone. Hence it is important that such a network is being established in Asia.
The World Bank, in one of its recent reports has estimated that AMR would increase the poverty rate and impact the low income countries more. Its studies have shown that the global GDP could decrease by 1 per cent and there would be 5 to 7 per cent loss in developing countries by 2050, which would translate into $100-210 trillion. Multidrugresistant TB alone is expected to cost the world $16.7 trillion by 2050. The UN report predicts that by 2030, AMR could force up to 24 million people into extreme poverty.
Only if the alarming AMR issue is tackled on a war footing can there be any hope of reducing its devastating impact on both life and economy. The ACRN could prove to be an important step ahead in the direction at the Asian level.