Antibiotic and antimicrobial resistance is a major threat to public health – described by the World Health Organisation as threatening the “core of modern medicine”.
It is driven by the slow pipeline of new medicines development by the pharmaceutical industry and the overuse of antibiotics by humans and in farm animals, particularly pigs and poultry.
Countering this is widely seen to require both tougher regulation and the enforcement of existing rules, where these even exist. In particular regulation is needed for the promotion of antibiotics by the pharmaceutical industry and tighter rules on their usage in animal agriculture.
The major O’Neill review called for a series of measures to tackle drug resistance, including a global awareness campaign.
The European Public Health Alliance draws recommendations for EU AMR policy from a spate of infections in Romania. Their proposals include investing in education of health workers on the threat of AMR, and tougher legislation.
Compassion in World Farming and World Animal Protection propose stronger regulation of farming antibiotics.
International cooperation is vital in the race to develop and distribute a safe, effective, affordable, and globally available Covid-19 vaccine.
Despite calls from low-income countries for greater levels of coordination, most rich countries are choosing to largely go it alone in the pursuit of Covid-19 vaccines that will serve their own populations first.
Governments are being urged to increase existing commitments to multilateral funding for international vaccine development, to prioritise cooperation through bodies such as the World Health Organisation, and to prioritise investing in global manufacturing capacity to ensure vaccines get to those that need them the most.
Coordinated by UNAIDS, more than 140 world leaders and experts signed an open letter calling for a "people’s vaccine" against Covid. They call for international action to ensure that all vaccines, treatments and tests for Covid-19 be patent-free, mass produced, distributed fairly and made available to all people free of charge.
The Centre for European Policy Studies recommends compulsory licensing for future Covid-19 vaccines whereby other manufacturers would be able to produce generic versions in low or middle income countries.
The OECD makes a series of recommendations for delivering worldwide vaccinations at scale, including investing now in scaling up manufacturing capacity.
The business model of the major pharmaceutical companies incentivises them to pursue the development of drugs that are potentially the most lucrative. This could mean focussing on treating chronic conditions experienced by elderly people in wealthy countries rather than researching diseases widely experienced in low-income countries.
Drug prices can be very high and companies hold effective monopolies for treatments – problems of particular importance during any pandemic.
It has been proposed that private industry should be better incentivised to develop the medicines society needs most. Others argue that the profit-led pharma business model is in need of more fundamental reform. with a more direct hand for governments in the medicines innovation process itself.
Some go even further, advocating new models of public ownership of key parts of the development and production process, and the government taking a greater equity stake in the medicines that it supports.
Global Justice Now and STOPAIDS explore the problems of high drug pricing and the lack of public return on investment. Their proposals include public interest conditions being attached to grant funding and enforcement of transparency on how drugs have been funded and their return on investment.
This 2016 UN/WHO paper discusses the problems of high drug pricing and what might done about it, including pooling intellectual property.
Corporate Europe Observatory and Global Health Advocates explore the influence of the pharmaceutical industry on Europe’s Innovative Medicines Initiative (IMI). They argue that corporate lobbying has meant the IMI is not sufficiently focused on the public good and conflicts of interest abound.