Innovative diagnostic technologies: an ally to address AMR
The excessive and inappropriate use of antibiotics and poor infection control practices have progressively turned antimicrobial resistance (AMR) into a massive threat for humankind. The misuse of antibiotics is eroding their efficacy and highly resistant bacteria - especially those resistant to last line antibiotics - are rapidly emerging and spreading across the globe. Moreover, such abuse represents one of the most significant drivers for developing multidrug-resistant bacteria. Patients receiving antibiotics are more likely to be colonised with multidrug-resistant bacteria and are thus at greater risk of developing subsequent infections than patients who do not receive antibiotics. Parallel to this phenomenon, the pipeline of new antibiotics is almost dry.
Innovative diagnostics for reducing healthcare associated infections and antibiotic consumption
Resistant bacteria know no borders. Once a person is infected, antibiotic-resistant bacteria spread to others and a high antibiotic consumption in a population (hospital setting or community) strongly favours such spread. Resistant bacteria kill 25,000 patients annually in the European Union, with extra healthcare costs and productivity losses of €1.5 billion each year. The cost of inaction is projected to result in 10 million deaths globally per year and a cumulative loss of over €88 trillion to the world economy by 2050. Cost-effective interventions able to protect public health and contain healthcare costs are urgently needed.
In order to tackle such emergency, there is an urgent need to prevent infections. Each year, it is estimated that 4.1 million patients across Europe contract a healthcare-associated infection (HAI), in hospitals or long-term care facilities. The most frequent HAIs are urinary tract infections, respiratory tract infections, and bloodstream infections. It is well estimated that infection prevention and control programmes, such as active surveillance, hand hygiene, screening, or isolation, are key elements to reduce antibiotic consumption and may prevent up to 30% of HAIs.
Preventing infections and reducing antibiotic misuse is possible. Screening patients for infections before entering hospitals, investing in new vaccines, incentivising diagnostic tests to prevent antibiotic misuse, enabling the uptake of technological solutions to prevent and control infections in hospital and healthcare facilities, as well as encouraging hospitals to publish data on infection and resistance rates - so that patients can make more informed choices - are critical elements to address effectively AMR. A multi-level and comprehensive strategy to tackle this public health emergency is needed. We have innovative diagnostic technologies which can contribute – as part of a broader plan - to tackle AMR by preventing infections and reducing antibiotic misuse. Why are they not implemented in our healthcare systems?
Despite their value and relevance, the uptake and implementation of new diagnostic technologies in national healthcare systems remain low due to a mismatch between the cost and the benefits of innovative technologies. Prescribing antibiotics is cheaper than using diagnostic tools which are perceived to be a short-term expense. Innovation in diagnostics needs to be seen as a long-term investment which could help to save costs, reduce waste across healthcare levels, and preserve the usefulness of antibiotics for everyone.
Joint efforts and shared practices for a healthier community
While it is clear that managing the use of antibiotics has become an important patient safety and public health issue as well as a global priority, it is now essential to work together and develop a multi-level and comprehensive strategy to tackle AMR, involving different actors and sectors, e.g. human and veterinary medicine, agriculture, finance, environment and consumers.
Diagnostic technologies along with prevention methods have the potential to dramatically reduce the misuse of antibiotics by creating a situation where antimicrobials are prescribed based on diagnosis and accurate procedures, not simply on presentation and clinical experience.
Based on the lessons learnt from the EU Action Plan on AMR 2011-2016, the European Commission is currently finalising the new Action Plan which will be launched in June 2017. As Health First Europe President, I welcome the European Commission initiative to move towards a broad plan focusing on three main priorities: making the EU a best practice region in addressing AMR, stimulating research and innovation, and shaping global engagement beyond EU countries. A multilevel and “one health” approach to AMR is critical to tackle this emergency. Here comes the imperative to apply knowledge and experiences and promote alternative therapies and diagnostics, revising reimbursement models to implement effective prevention and control policies, and support the development of new funding and business models, necessary to foster research and improve access to innovative technological solutions vital to prevent and control AMR/HAIs.
Not only there is a lot to do, but also a lot that people can learn from each other.