Taking a holistic approach to antimicrobial resistance
Antimicrobial resistance (AMR) is a growing threat to public health and could increase through the heavy use of antibiotics in the treatment of COVID-19 patients. While antibiotics have saved countless lives and treat numerous conditions, and are essential to many everyday procedures including surgery and chemotherapy, global health experts are increasingly concerned about a new “post-antibiotic” era in which common infections could once again kill. A UK government report estimates that without coordinated international action, AMR could lead to 10 million more deaths annually by 2050.
Sandoz statement of intent for addressing AMR: areas of focus
Prevention: initiatives to drive responsible manufacturing standards that help reduce the environmental impact of the production of antibiotics
Access: global and local collaborations with a range of partners to help improve access to anti-infectives
Stewardship: global and local initiatives to ensure prescription of the right drug at the right dose for the right duration
Innovation: non-traditional research and development to explore innovative solutions to prolong the life of existing antibiotics and improve patient adherence to therapy
Novartis supports the global scientific consensus that overuse, underuse and misuse of antimicrobial medicines all contribute to the spread of AMR, and that a balanced approach encompassing prevention, stewardship, access and innovation is needed. Improvements in water sanitation and hygiene as well as wastewater management will help prevent infections and reduce the spread of AMR. The global healthcare community should make every effort to safeguard and maximize the efficacy of the medicines we have today through appropriate use. Lack of timely access to appropriate antimicrobial treatments (particularly antibiotics) and the inability to perform accurate point-of-care diagnostics also contribute to the spread of AMR.
Sandoz, our generics and biosimilars division, is the world’s largest provider of high-quality, affordable generic antibiotics. We strive to ensure that our medicines are used in a responsible and sustainable way by engaging in global and local partnerships to support the use of antibiotics in line with WHO guidance. We work with health authorities and healthcare professionals throughout the world to foster stewardship and education, and with nongovernmental organizations and not-for-profit organizations to expand access to antibiotics regardless of patient affordability.
In July, we announced plans for a new public-private partnership with the Austrian federal government to strengthen the long-term future of antibiotic manufacturing in Europe. Sandoz plans to invest more than USD 175 million over the next five years in its integrated antibiotic manufacturing operations in Kundl, Austria, to implement innovative manufacturing technology for both active pharmaceutical ingredients (APIs) and finished dosage forms.
This is an important step toward stronger management of the production and supply of antibiotics in Europe. Sandoz produces enough penicillin products in Kundl to potentially meet all current Europe-wide demand. Under the agreement, we have committed to continue penicillin API production in Europe for the next 10 years. Further, as Kundl is the focal point of the Sandoz European antibiotic manufacturing network, making investments in this facility is vital to help ensure reliable, high-quality supply for European markets.
Novartis was one of 24 pharmaceutical companies that invested a total of USD 1 billion to launch a new AMR Action Fund in July. Developed with the European Investment Bank, the Wellcome Trust and the WHO, this groundbreaking initiative aims to bring two to four new antibiotics to patients by 2030.
Through the Global Antibiotic Research and Development Partnership, we are working to accelerate the development and availability of generic antibiotics to help reduce child deaths from drug-resistant infections. In 2020, we filed a heat-stable pediatric antibiotic for registration in eight African countries. This antibiotic treats a number of infections, including community-acquired pneumonia (pneumonia contracted in a community setting), acute otitis media (ear infection) and cellulitis (bacterial skin infection), especially in the case of penicillin resistance.
As a leading member of the AMR Industry Alliance since 2016, Novartis worked with other member companies to establish an industrywide framework for antibiotic manufacturing. While the contribution of pharmaceutical manufacturing to pharmaceuticals in the environment is relatively low, there is the potential for localized impacts when manufacturing effluents are inadequately managed. In addition, we recently joined the Responsible Antibiotics Manufacturing Platform, an alliance to combat AMR by producing antibiotics in a manner that is environmentally, socially and economically sustainable.