New approaches to combat Antimicrobial Resistance (AMR)?

Antimicrobial resistance (AMR) is a complex global health challenge arising from improper antibiotic usage in both human and animal domains, including the misguided application of antibiotics as growth promoters in animals. A deficiency in public understanding of antibiotics among diverse stakeholders further compounds this issue. The European Commission, primarily via its agency HERA (European Health Emergency Preparedness and Response), is now better prepared to confront a potential outbreak of totally resistant bacteria that may kill many more millions of people globally than COVID-19. However, the Commission's current strategy mostly emphasizes the acceleration of new antibiotic development to replace obsolete treatments rendered ineffective against resistant infections. The Commission also announced its intention to mandate the pharmaceutical industry, responsible for the overproduction of antibiotics that led to the AMR threat, to increase production of current antibiotics in anticipation of a potential rise in respiratory infections during the upcoming winter season. This article provides a critical overview of EU actions on AMR and delves into recent research, emphasizing a key insight: the development of new drugs is insufficient in combating AMR if these innovations inadvertently contribute to pathogen resistance. Concurrently, the study delves into fundamental components necessary for averting a potential global AMR crisis. These components encompass education, awareness, the imperative of equitable antibiotic access, and finally, the exploration of less resistance-creating alternatives, such as bacteriophages and vaccinations.Central to the discourse are the pivotal roles assigned to responsible global authorities and stakeholders. They are urged to take the lead in incentivizing the pharmaceutical sector towards the production of AMR-resistant antibiotics, with a paramount goal of arresting the emergence of AMR in pathogens. Moreover, the article underscores the significance of promoting the development of "reserve" antibiotics, primarily reserved for severe emergency cases to effectively decelerate AMR progression. In this context, the HERA approach emerges as an invaluable tool, optimizing resource utilization within private and public inventories, while concurrently limiting the availability of medications for less critical conditions.Confronting the existing market inadequacies in antibiotic development, particularly within animal husbandry, necessitates the implementation of targeted regulatory measures including legal bans, antibiotic usage taxes and a halt to antibiotics sales through veterinarians – sometimes supported by substantial price reductions for quantum sales to farmers. The Commission is on record to ‘regret’ such practices but asserts its inability to act against them. In other words, to comprehensively address AMR, an all-encompassing global strategy reminiscent of the United Nations' Tuberculosis (TB) action is advocated, and the Chinese law banning the use of human-targeted antibiotics in animals may serve as a remarkable example. Integral to this strategy is the establishment of dynamic public-private partnerships, essential for orchestrating a unified response to the multifaceted challenge of AMR, while avoiding the pouring in of tax monies without the required public control over the actual use of antibiotics by pharmaceutical industries.