Beyond the AMR Action Fund: PBS NewsHour and Things for us all to do!

Dear All (and with thanks to Kevin Outterson for co-authoring this newsletter),

While we’re all thrilled with the announcement of the AMR Action Fund (newsletter), we’ve also had in parallel a demonstration of why the fund alone is insufficient to solve the antibiotic innovation crisis (newsletter on withdrawal of plazomicin’s marketing application in Europe).

Thus, it’s a good time to talk about next steps. AMR is complex but actions that would matter are within the grasp of our community. As a start for today, let’s consider 2 powerful themes that are open to immediate action by us all:

#1: Tell the story!

• As one idea, we can start with the recent excellent 2-part PBS News Hour story on AMR hosted by Paul Solman. Please watch and then share these clips:
  • 29 Jul 2020: “As a virus ravages the world, antibiotic makers are in disarray”: link
  • 30 Jul 2020: “How a crumbling antibiotics infrastructure could yield catastrophe”: link
• And in case you missed the prior video reports by PBS:
  • 22 Oct 2013 (PBS Frontline): “Hunting the nightmare bacteria” (link)
  • 2 Aug 2017 (PBS NewHour): “We are running out of effective antibiotics”: link
  • 3 Aug 2017 (PBS NewHour): “The financial barrier” (link)
  • 4 Aug 2017 (PBS NewHour): “Is there an economic cure for the problem?” (link)
  • 9 Aug 2017 (PBS NewHour) “How industrial farming techniques can breed superbugs” (link)
  • 10 Aug 2017 (PBS NewHour): “The economic reason this chicken producer gave up antibiotics” (link)
• In short, share the story widely (and in non-technical language) with folks outside our AMR bubble!
  • A great place for ideas is the data from Wellcome Trust’s exploration of language that really works (link).
  • The key idea is to talk about how AMR impacts your life and work, what you’re doing to address it, and what specific efforts are needed by others.
• You can do this by…
  • Sending an email to your member of Congress: https://workingtofightamr.org/act-now/
  • Recording an inspiring patient story on AMR: https://workingtofightamr.org/covid-19-and-amr/
• For more detailed ideas to share, look also at the list in the 5 May 2019 newsletter about the collapse of Achaogen (link):
  • Timely guideline updates from professional societies
  • Updated health technology assessment approaches (the UK continues to lead here; link)
  • Action by political leadership
• If nothing else, let’s all start using #FireExtinguishersOfMedicine in our tweets … it’s such a simple but powerful meme! 

#2:  Support calls for substantial post-approval Pull Incentives from the G7, if not (most of) the G20

• Making Pull Incentives happen is the most efficient way to drive the overall ecosystem!
  • Without lifetime Pull Incentives of $1-$4b for really innovative new drugs (see this newsletter for the math), private investment and expertise in antibiotic development will disappear
  • We’re already seeing this: companies with approved products are already going bankrupt. In effect, you will be able see new drugs but not have them.
  • The G7 countries could deliver the bulk of the needed Pull Incentives, but adding the G20 countries (India, China) would make a powerful difference.
• These Pull Incentives are especially needed to provide the funding after initial approval that supports the costs of keeping a drug on the market and of the additional data packages needed to inform appropriate use.
  • Initial approval is at most the half-way point in a drug’s development and we must make it possible (indeed, desirable) for the developer to generate those data that make a difference (e.g., pediatrics).

Get to it, use that #FireExtinguishersOfMedicine hashtag, and stay safe!

All best wishes, John & Kevin

John H. Rex, MD | Chief Medical Officer, F2G Ltd. | Operating Partner, Advent Life Sciences. Follow me on Twitter: @JohnRex_NewAbx. See past newsletters and subscribe for the future: https://amr.solutions/blog/. All opinions are my own.

Kevin Outterson, JD, Professor of Law, Boston University & Executive Director, CARB-X (these views are personal and do not necessarily reflect the views of CARB-X or any of its funders) @koutterson