Drugmakers are making an effort to improve access to antibiotics, but it’s far less than the scale of requirement, says Jayasree Iyer of the Access to Medicine Foundation (ATM) in the latest report on anti-microbial resistance (AMR).

“Just one-third of the (66) products examined have any kind of access strategy in place, such as price adjustments to make medicines more affordable, or licensing agreements to boost supply to low- and middle-income countries. This leaves millions of people without access to the right treatments for infectious diseases,” said the 2021 Antimicrobial Resistance Benchmark, released by ATM, a non-profit organisation.

“Pharma companies must ensure they do not repeat the unacceptable inequities seen in Covid (treatments), when it comes to antibiotics and the fight against superbugs,” said Iyer, speaking to BusinessLine from Netherlands. (Superbugs are infection-causing bacteria that are not treatable by existing medicines, antibiotics).

An estimated 750,000 people die each year due to drug-resistant infections. Also, 5.7 million people die from treatable infectious diseases, due to a lack of access to medicines, said the report.

Data were investigated from 17 of the largest pharmaceutical companies that produce antibiotics and antifungals (by volume and value of sales). A clutch of generic Indian companies also featured in the report, for efforts to ensure cleaner manufacture of antibiotics, besides making sure they were not promoted unnecessarily. Companies are working towards limiting their antibiotic waste discharge into the water or environment and are providing leadership in improving access to their products, said Iyer.

Pointing to meetings with the top-brass of companies, including Aurobindo, Cipla and Sun Pharma, she said Indian companies were undertaking efforts to control AMR, despite the challenges of operating during the peak of the pandemic. She did, however, add that companies like Alkem must be more transparent on their efforts.

Supplier standards

Fatema Rafiqi, Research Programme Manager-AMR, said generic companies were outlining and adhering to environment risk strategies themselves, and are asking this of their suppliers as well. While Cipla scored on that count, she pointed out that companies like Aurobindo were marching ahead with more transparent strategies and disclosures.

The Benchmark previously reported an increase in pharma companies that had stopped the use of sales agents altogether, or which decoupled agents’ bonuses from sales volume. In 2021, three more generic medicine manufacturers took action to combat overselling – Abbott, Aurobindo and Viatris.

Further improvement was also seen, with generic producers stepping outside “the high-volume, tender-led model seen as typical for generics, for example, by licensing their own on-patent antibiotics to new partners to boost supply and global access”, it noted.

New medicines

The engagement of large drugmakers with antibacterial and anti-fungal product research had stabilised, the report noted, following pressure from civil society and national governments to push for the development of replacement medicines.

There are potential game-changers being tested by the companies evaluated by the study, but the pipeline of new medicines and vaccines remains small, it added.

Info-box

Research companies covered include GSK, Johnson & Johnson, Merck & Co (MSD), Novartis, Ostuka, Pfizer, Sanofi and Shionogi. Generic companies included Abbott, Alkem, Aurobindo, Cipla, Fresenius Kabi, Hainan Hailing, Viatris, Sun Pharma, and Teva.

To assess access efforts, the study looked at actions to improve access in 102 low- and middle-income countries. To assess research, it examined research companies’ projects targeting pathogens that pose the highest risk of drug resistance, according to the US Centers for Disease Control (CDC) and the World Health Organization.

This is the third AMR Benchmark. It is funded by the UK and Dutch governments, AXA Investment Managers and Wellcome Trust.

comment COMMENT NOW