OECD WORK ON AMR: TACKLING THE NEGATIVE CONSEQUENCES OF ANTIBIOTIC RESISTANCE ON HUMAN HEALTH Michele Cecchini OECD Health Division
Antimicrobial Resistance is a Global Threat Modern medicine and surgery are not possible without antibiotics 50 40 Higher use of antibiotics drives resistance Penicillin-resistant S. pneumonia (%) Spain France AMR is largely human-driven - Inappropriate use in humans - Overuse in livestock - Insufficient hygiene in hospitals - Global trade & travel The development pipeline of new antibiotics is drying up 30 20 10 Greece Canada Ireland Iceland Austria Germany UK USA Portugal Luxemburg Italy Belgium Denmark Sweden Australia Netherlands Norway Finland 0 5 10 15 20 25 30 35 Total antibiotic use (DDD/1000 people/day)
AMR Causes a Significant Health Burden 1 in 5 human infections in G7 countries is resistant to antibiotics Patients infected by resistant bacteria are more likely to incur health complications x 3 probability of local progression for resistant infections x 2 risk of any complication for resistant infections x 3 Risk of death for resistant infections 700,000 deaths per year globally 50,000 in Europe and North America
AMR has a Large Cost for Healthcare Systems Hospitalised patients with antibiotic-resistant infections costs an additional 10-40k USD Other items Over half of extra Nursing 38% 19% 2% Pharmaceuticals expenditure is due to nursing and medical care 16% Medical care 13% 12% Lab tests & imaging Support services 23b USD additional healthcare spending in Europe and North America per year
GDP loss (percent per year) AMR has a Negative Economic Impact Productivity loss 38K USD per patient due to AMR Total GDP effects of AMR including increased healthcare expenditure 0.0% 2020 2030 2050-0.03% -0.1% -0.2% -0.2% -0.2% labour force 2.1m deaths by 2050 amongst working age population wider economy impact -0.4% -0.6% -0.8% -1.0% current resistance rates -0.3% -0.8% 100% resistance rates
Some Countries Have Made Significant Progress but Global Response is Limited CAN, DEU, EU, UK, USA have comprehensive plans; FRA, ITA, JPN have specific policies Policies reviewed along 7 dimensions Focus on enforcement & ownership and on targets & evaluation Role of bilateral and multilateral efforts Global response to AMR Surveillance system Prevention and control programmes National policy 50%
Responding to the Rise of Antimicrobial Resistance Avoiding the emergence Avoiding the spread Stimulating R&D Stewardship programmes Immunisation programmes Price policies Early detection Measures to reduce infectivity Enhance sanitation and hygiene in medical facilities De-linking development incentives from sales Lowering early development costs and boosting rewards at the end of the process. Global research platforms Overarching bottlenecks to implementation: Consensus on implementation, guidelines, legislation Commitment (funding, review) Ensuring long-term effects Leadership Evidence on effectiveness and cost-effectiveness is still limited
OECD Recommendations to Move Forward in the Fight Against AMR Coordinating with global partners like the G20 to efficiently upscale G7 efforts into a global action Strengthening existing surveillance and monitoring systems Adopting globally agreed sets of measurable targets on AMR incidence and efficient antibiotic use Strengthening ongoing efforts to rationalise antibiotics use and prevention of AMR spread Fostering R&D through a global collaborative research platform, and by delinking development from sales
OECD is Ready to Stand Next to Countries Assessing the effectiveness and costeffectiveness of innovative actions Actions aimed at avoiding the emergence and the spread of AMR Impact on health, healthcare budgets and the broader economy Potential huge benefits for policy-making by including the livestock sector Reviewing national plans and strategies Focus on rationalising prescriptions: stewardship programmes, training and awareness raising Part of the publication for the 2017 OECD Health Ministerial meeting thenounproject.com: Marioni, Helbig, Demushkin