Superbugs will kill 10 million people a year by 2050 — more than cancer does now — if the world does not take action immediately, a major report commissioned by the British government has found.
Drug companies must be forced to "pay or play" in the urgent race to develop new antibiotics, said former Goldman Sachs chief economist Jim O'Neill, who led the influential 18-month review, or medicine will be "cast back into the dark ages."
Every sector affected by the growing threat of superbug infections — from patients, to doctors, to governments, to the healthcare industry — must be forced "out of its comfort zone" if the issue is to be successfully tackled, said O'Neill, who became a government minister while working on the report.
This should include pharmaceutical companies, O'Neill said, which should be subject to a surcharge if they decide not to invest in research and development (R&D) to bring successful new antibiotic medicines to market.
For those who do decide to "play," he said, a reward of between $1 billion and $1.5 billion should be paid for any successful new antimicrobial medicine brought to market.
"If we don't do something, we're heading towards a world where there will be no antibiotics available to treat people who need them," O'Neill told reporters at a London briefing as he presented a final report from his team's review.
In that scenario, superbugs could kill one person every three seconds and cost up to $100 trillion within 35 years.
O'Neill was asked last year by Britain's Prime Minister David Cameron to conduct a full review of the problem and suggest ways to combat it.
Launching his final report, O'Neill called for dramatic changes in how antibiotics are used, which was the only way to "change the game permanently."
Doctors needed to "stop treating antibiotics like sweets," instead using tests to make sure an infection is bacterial before prescribing them. Rapid diagnostic tests should be mandatory by 2020, he said.
He also called for a global agreement to drastically cut the amount of antibiotics used in agriculture, and an outright ban on farmers using colistin, an antibiotic used to treat the most drug-resistant infections.
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Since the review began in mid-2014, 1 million people have died from such infections, and bacteria resistant to colistin have been discovered.
The report identified 10 areas where the world needs to take action. Some of these focus on how to reduce unnecessary use of antibiotics, while others look at how to increase the supply of new ones.
It recommends a massive global awareness campaign, improved access to clean water and sanitation, and the setting up of a $1.4 billion global fund to pay for early stage research.
O'Neill said the review's proposals would cost up to $40 billion over 10 years — a figure "dwarfed by the costs of inaction." A little more than half of that — up to $25 billion — should probably come from the drugs industry, he said.
He suggested several possible funding sources, including allocating a small percentage of G20 countries' health spending, reallocating a fraction of global funding from international institutions, applying the "pay or play" charge, and taxing current antibiotic use.
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