EU lagging behind on antimicrobial resistance research

EU member states are trailing other countries when it comes to research into antimicrobial resistance, a growing public health problem that promises to unleash a “slow pandemic”, undoing some of the gains of modern medicine.

Overuse of antibiotics has led to some bacteria developing resistance to current treatments, leading to a growing number of lethal infections with few new drugs in sight.

In Europe, 33,000 people died as a result of drug-resistant bacterial infections in 2020, more than flu, tuberculosis and HIV/AIDs combined, and the problem is predicted to get worse as resistance grows.

Globally, drug-resistant bacteria are estimated to have killed 1.27 million people in 2019, more than malaria. The World Health Organisation estimates this could rise to 10 million by mid-century.

A new report tracking global research into antimicrobial resistance finds that the US, China, UK, India and Australia are the leading nations in this research field, having published more papers since 2000 than any EU state.

Germany is the most prolific EU country, with nearly 6,000 publications, which is around half the output of the UK or India.

Iran has published more papers on the issue than France, followed by Canada, then Italy, according to The Antimicrobial Resistance Research Landscape and Emerging Solutions report from the Center for Security and Emerging Technology, a think tank based at Georgetown University in the US.

There are no EU universities or research institutes in the top ten producers of antimicrobial resistance research. That table is led by Harvard University, followed by Oxford, the US Centers for Disease Control and Prevention, and John Hopkins University.

That is despite the fact that the European Commission is one of the biggest global funders of antimicrobial resistance research, though no national EU member state funding agencies make the top ten. The field has been one of the key priorities for health research in the Horizon Europe framework programme.

The report also tracks research into novel approaches to circumventing antimicrobial resistance, such as phage therapy, which uses viruses to target bacteria, or the synthesis of antimicrobial therapies not found in nature. Research into these areas is growing, but from a low base, and the report recommends policymakers boost spending on these new drug classes.

Antimicrobial resistance is a particular priority for public funding agencies because the pharmaceutical industry has all but stopped developing new antibiotics.

A key problem is that the antibiotics market in Europe and elsewhere is broken, because preserving effectiveness of new products requires measures to limit their use, while health technology assessments invariably weigh them against cheap generics, underestimating their value.

“The clinical pipeline of new antimicrobials is dry,” the World Health Organisation warned in 2021.