Antibiotics overuse: ‘India must be part of solution’

The Indian generic drugs industry and diagnostic companies will have a major part to play in global attempts to reduce the inappropriate use of antibiotics, which threatens to create a health crisis globally, said Jim O Neill, economist and chair of a major review of anti-microbial resistance.

O’Neill, former Chief Economist at Goldman Sachs and who coined the “BRIC” acronym, spoke to BusinessLine about the crucial role that Indian generic drug makers and diagnostic companies could play in meeting the global challenge.

The review, commissioned by the British government, but drafted by working with governments and NGOs globally, had launched last year.

It published a series of reports relating to the abuse of antibiotics. The latest report, published last week, focuses on the importance of developing cost-effective and speedy diagnostic tools to ensure that conditions are diagnosed properly, and the most appropriate narrow spectrum antibiotic is given.

It recommends the development of a global research and development fund for anti-microbial resistance (AMR), part of which will go towards new research on diagnostics globally.

It also recommends setting up of a second fund to reward diagnostic tools with subsidies and incentives, to make it easier to tackle the costs of diagnostics.

The review estimates that as many as 10 million people globally could die by 2050 because of growing resistance to antibiotics, that has resulted from the over use and inappropriate prescribing of antibiotics, which had become a major problem globally in the developed and developing world.

O’Neill, said the review recognised the particular challenge in BRIC nations, where many lacked even basic access to antibiotics.

“We don’t suggest that people shouldn’t get the right antibiotics. In many parts of the world, there is a huge need for the right kinds of antibiotics to preserve and lengthen people’s lives — we want to be clear that it should happen more and better, but in order to help that, we need to have better objective indications as to when they are really necessary rather than used, because they might be of some benefit.”

O’Neill said that Indian diagnostic firms were likely to play an important role, citing the example of SRL Ltd, whose Managing Director Sanjeev Chaudhry is an advisor to the review.

“The firm stands as one of the important things we’ve come across — even here in the UK, two of the top British hospitals send blood samples to its laboratories in India for tests because of better technology and affordability.” He also expects the generic drug industry to play an important role, with Yusuf K Hamied, Chairman of Cipla, recently joining as an advisor.

“People would rightly say he has personally been responsible for saving millions of lives through generics, and we think there is a huge role for that to be a central part of the solution.

“It is part of the challenge because a lot of big western pharma companies want to focus on drugs that they are protecting from competition for as long a time as possible and at a higher charge. But for something that is a public and global good, we need to find the right set of incentives and rewards to help them behave and think differently. The way Cipla has approached life is a fantastic example and something we want to endorse.”

While much of the data in the report focuses on western markets, including the US — where according to one study in the report, as many as 27 million of the 40 million people given antibiotics for respiratory conditions annually were wrongly prescribed — there was a “strong suspicion” that in emerging markets it was a major problem, said O’Neill.

“We’ve had some success calling for funding of greater data surveillance; how evidence is collected by health authorities. Having state-of-the-art surveillance techniques so you can make judgments about aspects of AMR, is important.”

O’Neill had led a visit by the AMR review team to India in March. “The question is: can you get India to be at the centre of finding a solution, along with other parts of the emerging world, rather than being carried along by what the developed world tells it to do? It’s an important bias of mine to ensure emerging countries play a central role.”

He said he welcomed growing signs that BRIC nations were looking to coordinate work on the challenge of drug resistance, particularly in areas such as TB, HIV and malaria.

“India is travelling in the right direction with Prime Minister Modi’s focus on the Clean India campaign — it’s an important part of the puzzle, and we are trying to pose the AMR challenge in India in the context of that campaign.

“I believe that ahead of his trip to the UK, the specific focus on AMR is rising as a policy priority.”

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