AMR takes center stage in New York

SNEAK PEEK

— Antimicrobial resistance takes center stage in New York, which will host the first high-level meeting on the issue since 2016.

— Dispatches from Gastein: The EU’s competitiveness craze is an open goal for corporate lobbyists, health NGOs warn.

— The EU should introduce pull incentives to promote R&D for neglected diseases, panelists said.

Welcome to Thursday’s Morning Health Care! Researchers have discovered the long-awaited elixir of life: being from Malta. The island nation has the most expected healthy life years, for both men and women, in the EU.

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DRIVING THE DAY

AMR HAS ITS MOMENT IN NEW YORK: Global leaders and experts will gather today in New York for a high-level meeting on antimicrobial resistance (AMR), at the United Nations General Assembly. We’ll get statements from the heads of U.N. agencies, AMR survivors, health ministers, Big Pharma executives, as well as country reps. 

Why it matters: The meeting is significant for two reasons — first, we have a political declaration to curb AMR, but also we have world leaders talking about one of the biggest threats to human health today and in the years ahead.

Who’s there? European Health Commissioner Stella Kyriakides is in town to deliver the EU’s statement in the plenary. U.K. Special Envoy on AMR Sally Davies, WHO Director-General Tedros Adhanom Ghebreyesus, GSK CEO Emma Walmsley, and Jean Kaseya, director-general of the Africa Centres for Disease Control and Prevention will all be there too.

What about the declaration? Leaders are expected to adopt a 15-page document that experts hoped would be an ambitious rallying call, full of commitments to end widespread antibiotic misuse, promote new drug discovery and guarantee equitable access.

So what have we got? Not that. Successive drafts of the text have been watered down amid “heated” discussions, with divisions emerging over financing, obligations on the pharmaceutical and agricultural industries, the sharing of new technology, and equitable access to new drugs.

Industry feels seen: The pharmaceutical industry seems satisfied that their views were taken on board, with language “acknowledging the important role played by the private sector” in the development of new drugs. Now governments should follow up and give industry the “pull incentives” they need to make the numbers on new antibiotic development add up, James Anderson, chair of the AMR Industry Alliance, told Rory.

Market failure: One of our biggest problems is that the industry isn’t coming up with new antibiotics. The reason is simple — it’s expensive, high-risk work that may not deliver significant financial returns. Not the kind of thing investors typically go for. Anderson saw promising molecules dropped from development at a former company because the commercial teams said “the economics do not add up.” 

Other models are available: Not everyone is happy to reward market failure with a new basket of incentives. Some AMR researchers argue industry’s inability to produce new drugs for profit underlines why we need to invest in public R&D instead. There is also the Global Antibiotic Research & Development Partnership, a not-for-profit co-founded by WHO and the Drugs for Neglected Disease Initiative in 2016. 

Civil society shut-out? Jasmina Cunmulaj, a manager at the European Public Health Alliance, says civil society organizations aren’t a priority at UNGA. “Visa restrictions and delayed invitations have unfortunately prevented many representatives from attending the #UNGA79 in person, underscoring the structural limitations still in place,” Cunmulaj wrote on LinkedIn.

LOBBYING

OVER IN GASTEIN: The recent focus on Europe’s competitiveness is going to have the (unfortunate?) knock-on effect of making it easier for industry to influence policies, health NGOs warned on day two of the European Health Forum Gastein, on Wednesday.

Ursula von der Leyen wants to hold “regular dialogues” with businesses, which, combined with a focus on competitiveness since the release of Mario Draghi’s report, is going to make it easier for the likes of the tobacco or vaping industry to get involved in conversations and lobby their interests, Caroline Costongs, the director of EuroHealthNet, a partnership of public health organizations, said.

Spelling it out: “It will be easier for lobbyists to get engaged in policymaking, because VdL herself said in her political guidelines that she wants to make things faster and easier and simpler for all businesses,” Costongs said. The push of big corporate industries has already hindered countries’ progress in meeting their targets on non-communicable diseases, panelists argued.

Pressure at home: Pedro Gullón, director general of public health and equity at the Spanish Ministry of Health, said national governments feel this pressure too — through lobbying, demonstrations and other ways to exert influence. And these tactics are working, both at the national and EU level.

The impact: “The fact that there are substantial delays … in the Beating Cancer Plan says a lot,” Costongs said. Although the Commission last week released one strand of the plan on smoke-free environments, other areas of the plan are stuck. “The lobbyists know exactly which sectors to lobby,” she added.

Scale of the lobby: Pharma company Bayer spends over €10 million alone on lobbying in the EU, Hans van Scharen, a researcher and campaigner at the Corporate Europe Observatory said, citing a report the organization released this week. 

**A message from MedTech Europe: Medical technologies play a vital role in preventing and controlling healthcare-associated infections by detecting bacterial threats, monitoring resistance, ensuring antibiotic compliance, and tracking pathogens to stop their spread locally and globally. That’s the #PowerOfMedtech.**

PUBLIC HEALTH

TRUST, TRUST, TRUST: When it comes to connecting with citizens on public health, trust is everything, delegates at Gastein heard. It’s vital for an effective health crisis response, pointed out Pamela Rendi-Wagner, the new head of the European Centre for Disease Prevention and Control (ECDC). “We have to build up trust and communication,” she said, “these are a very important pillar of preparedness for the next time.” 

But trust has to be earned: ECDC is doing this by using AI to scan for harmful fake news in health, and quickly countering it with evidence-based facts. For scientists, however, this is not easy, pointed out MEP András Kulja. Fake news spreads like wildfire online, whereas it takes time to generate evidence, putting truth “at a disadvantage,” he said.

Here’s someone who can help: Patient groups are valuable at stamping out disinfo, pointed out Scott Greer, professor of global health management and policy of the University of Michigan, U.S. “Patient engagement helps to reduce right-wing bias of people with ill health,” helping them to trust the system more, he said.

Wise words: “Let’s not get too fixated on the end — trust is a means to the end and the end is improving public health,” cautioned Nason Maani, lecturer in inequalities and global health policy, at the University of Edinburgh. 

Quote of the day: Trust is also vital for encouraging behaviors or implementing legislation against the commercial determinants of health, like fast food, Big Tobacco or booze.

“I come from a part of Germany where the Weisswurst is very popular,” said moderator Ilona Kickbush, a public and global health consultant, adding that this white sausage supposedly gives people a feeling of “happiness.” 

“I think we’re up against a lot if wellbeing is now determined by sausages.”

NEGLECTED DISEASES

PULL INCENTIVES AND NEGLECTED DISEASES: The EU should introduce more pull incentives, such as priority review vouchers (PRVs), to stimulate research and development (R&D) of vaccines and treatments targeting neglected diseases, panelists at another Gastein panel said.

Neglected until they aren’t: Neglected diseases are largely absent from the health agenda, with often no or few vaccines and treatments available. They include malaria, dengue, chikungunya and other diseases which predominantly affect people living in low middle-income countries. That’s why they are neglected — until they reach the west, and suddenly aren’t, panelists said.

“They are neglected diseases because they’re geographically focused,” said Kickbusch, founding director and chair of the Global Health Centre at the Graduate Institute for International and Development Studies Geneva. “The more it comes our way the less they will be neglected because we will start to be concerned about ourselves.”

Two examples: That’s what has happened with dengue and mpox, which are “scaring everybody” today, but were actually “for many years neglected tropical diseases,” Joelle Tanguy, external affairs director at Drugs for Neglected Diseases initiative told POLITICO on the sidelines of the event. “Now they’re becoming a health threat for us and we find ourselves without the drugs that were necessary.”

Enter pull incentives: But investing in neglected diseases is not easy, as there is virtually “no market” for them, Tanguy said. “The EU has been doing a lot, but the majority, or almost exclusively, all of the funding from the EU has been what we call push funding,” for research, said Rosa Castro, senior advocacy officer at Deutsche Stiftung Weltbevölkerung (DSW), which organized the panel. “That’s not enough.”

Let’s talk vouchers: Pull incentives could include priority review vouchers, which would allow companies who develop medicines to tackle neglected diseases to get fast-tracked regulatory review for another drug, or to sell the vouchers. The system already exists in the U.S. and some are arguing that it would be beneficial to introduce it at the EU level. “It’s a relatively simple way of putting something up, it doesn’t slow down everything but accelerates,” Olivier Jankowitsch, vice president for governmental affairs at Valneva.

EUROPEAN COUNCIL

DRUG LICENSES IN THE COUNCIL: EU country reps are meeting today to discuss a new compromise proposal on the procedures for medicines’ national marketing authorizations, in the overhaul of the pharmaceutical legislation. So far the talks on the authorization cluster have been going smoothly. 

And on Wednesday, country reps discussed the first compromise text of the Council conclusions on cardiovascular health and Council recommendation on smoke- and aerosol-free environments, unveiled by the Commission last week.

WHAT WE’RE READING

The world is teeming with drug-resistant pathogens. Health Policy Watch reports from the One Health Congress in Cape Town.

A new study has found one in three children are short-sighted, BBC reports.

Doctors are using AI to correspond with patients, in The New York Times.

**A message from MedTech Europe: Antimicrobial Resistance (AMR) and Healthcare Associated Infections (HAIs) are major global public health threats, which risk taking us back to the ‘pre-antibiotic era’, where simple bacterial infections could be life-threatening, and life-saving treatments can no longer be performed safely. Across the EU, about 33.000 people die each year from drug resistant infections. Medical technologies are game-changers in the fight against infections and resistance. They help us quickly detect and identify bacterial infections, monitor resistance patterns, and ensure antibiotics are used correctly. By tracking and containing pathogens, these technologies contribute to managing infections at every level—from local hospitals to global health systems. That’s the #PowerOfMedtech. Discover more.**