Lord Jim O’Neill, the economist who coined the term BRICs (referring to five major emerging economies), wants the International Monetary Fund (IMF) to think about superbugs when they are evaluating developing economies.
He suggested that the IMF should factor in whether antibiotics are being used in a responsible way as part of its in-country assessments. The Fund's assessments can determine whether a country is eligible for financial assistance. Reducing the use of the drugs can help prevent the spread of global superbugs.
O’Neill, who chaired the government’s review into the problem of antimicrobial resistance (AMR) today launched his new book: Superbugs: An Arms Race Against Bacteria, which outlines the major failures that led to the growing crisis and sets out a set of solutions to tackle it. It is also authored by his two policy advisors for the review, Anthony McDonnell and William Hall.
Professor Dame Sally Davies, England's Chief Medical Officer, said at the launch event for the new book on Thursday that we are yet to "crack the economic problem".
Speaking before a summit organised by the Bureau into the threat of superbugs, Lord O’Neill reiterated a call made in his 2016 report for countries to cap their use of antibiotics in agriculture. When discussing how to persuade governments in developing countries to cut use of the drugs in animals, he said: “We should get the IMF to have a role, in its article IV reports”.
Article IV consultations are a process in which the IMF stipulates the conditions countries must meet to access funding, as part of a report produced after visiting the country and meeting parliamentarians and business leaders.
O'Neill wants a responsible policy on how to deal with the threat of superbugs to be one of those conditions. A knock-on effect of not being able to access IMF funding is that a country’s credit rating could be negatively affected, which would incentivise them to act, O’Neill added.
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Drug resistance has been called the biggest public health crisis facing public health food security and development. In his report, O’Neill estimated there could be ten million extra deaths from superbugs by 2050, if no action is taken, and it could cost the global economy $100 trillion.
O’Neill said there had been some action on the issue since his report was published but said there had been little meaningful action in three areas: pharmaceutical companies developing new antibiotics, new diagnostic tests and using vaccines in livestock to mitigate use of antibiotics.
He reiterated this yesterday, saying there had been a "huge amount of endless talk about a model for new drugs". But after more than 100 pharmaceutical companies and associations agreed to tackle AMR in 2016, "I'm not aware of any of them actually having done anything different".
He said that the use of colistin - a last-hope antibiotic, crucial for treating human infections - should be banned in livestock immediately, along with all other crucial antibiotics.
He called on pharmaceutical companies to be more transparent about the waste they release from factories during the manufacturing of antibiotics. In January this year the Access to Medicine Foundation’s report on the pharmaceutical industry’s response to antimicrobial resistance showed that no company would publicly disclose the level of discharge they release, a finding O’Neill described as “unacceptable”.
However, he said that if companies were forced to disclose levels they would simply “get around it”. An independent index which names and shames poorly performing companies is the best way to influence behaviour, he said, adding that he hopes the new benchmark influences stock market analysts. “It is that which is going to influence pharmaceutical companies to change their behaviours”, he said.
He also called on the food and animal industry to stop lobbying government to quash the idea that there is no harm in using antibiotics in animals. “We did the largest ever survey of research and the five per cent of studies which showed there was no harm included those funded by the food industry. The government needs to face food industry lobbying and ignore it.”
He had seen momentum towards more responsible use of antibiotics from the industry. “It is important that this continues and is serious,” he said.
Photographs of Lord O'Neill at the Bureau's superbugs summit event in Westminster via Rob Stothard