Antimicrobial resistance (AMR) happens when microbes — or tiny germs such as bacteria, viruses or fungi — evolve in ways that make the medicines used to treat them stop working.
Before the Covid-19 pandemic, deaths from AMR decreased by 18%, but the pandemic erased years of progress, according to the Centers for Disease Control and Prevention (CDC). Fighting AMR will require developing new medications to treat evolving bugs and strengthening the healthcare supply chain to avoid disruptions and the risk of medication shortages.
To understand how fighting AMR can help us prepare for the next pandemic, we spoke to Erika Satterwhite, head of global policy at Viatris, a global pharmaceutical company that is a member of HealthyWomen’s Corporate Advisory Council.
The transcript has been lightly edited for clarity and length.
HealthyWomen: What role do you see AMR playing in the next pandemic?
Erika Satterwhite: According to a comprehensive analysis published in the British medical journal The Lancet, bacterial antimicrobial resistance or AMR was a factor in nearly 5 million deaths in 2019, placing it just behind heart disease and stroke among the top three causes of death worldwide. And that’s not even factoring in fungal and viral AMR. This phenomenon hits young children particularly hard: globally, one in five deaths attributable to AMR occur in children under 5 years old. So, I think it’s safe to say that it’s a present issue, leading cause of death globally and should absolutely be a key consideration in any conversations or preparedness measures being taken for the next pandemic.
HealthyWomen: How did the Covid-19 pandemic affect the fight against AMR?
Erika Satterwhite: One of the takeaways from Covid-19 is that global problems like AMR need global solutions. But, in the absence of those broad-reaching solutions, local policies can go a long way to opening up access to critical medicines for the masses. Now is a time where the need for solutions on all levels is clear and has prompted collaboration from a variety of stakeholders to tackle the problem.
HealthyWomen: How would combating AMR strengthen the healthcare system?
Erika Satterwhite: The most obvious answer is that we’d preserve our ability to successfully treat infections like pneumonia or sepsis. But there are ripple effects, too: Effective antibiotics are critical to many aspects of the healthcare system that may not be readily apparent. For example, chemotherapy, hip replacements and cesarean sections all rely on antibiotics to prevent infection. Combating AMR provides resiliency to the system by preserving our ability to treat a wide range of conditions.
HealthyWomen: What tools would help in the fight against AMR?
Erika Satterwhite: Successfully fighting AMR requires a multipronged approach. Some tools that would help fight AMR include:
Proactive prevention of infections through increased efforts in hygiene and sanitation, hospital-based infection control and vaccination (both for bacterial pathogens and for viral infections, which will prevent overuse/misuse of antibiotics)Education of healthcare providers and patients about the proper use of antibioticsBetter stewardship of existing antibiotics by using them only when relevant, at the appropriate dose and for the right amount of time, an effort that requires accurate diagnoses Collaboration by a variety of disciplines, including industry, nongovernmental organizations (NGOs) and governments to develop new ways to address unmet needs and ways to remove barriers to accessing antibiotics
HealthyWomen: What could be done — and who should be responsible — for strengthening the supply chain to avoid shortages of antibiotics?
Erika Satterwhite: One of the key issues in the antibiotic supply chain is the importance of preserving a wide variety of antibiotics. What this means in practical terms is that we need many medicines to be available, even if they aren’t used often. Several antibiotics have been available as generics for many years, and yhe prices for some of them are so low, it’s not economically viable for companies to keep making or selling them. This can lead to an unhealthy concentration of the market, which can lead to a higher risk of supply disruption. We need to preserve the availability of these older products to ensure that we have the widest array of options possible to treat infections that may be resistant to certain antibiotics.
As you may imagine, this is an issue that needs all hands on deck to troubleshoot. Policymakers and payers need to recognize the value of market incentives for older products in addition to new product introduction. Industry, NGOs and governments need to find new ways to partner on strategies such as improving public awareness.
Globally, governments should work together through surveillance networks and data-sharing and commit to secure global supply chains to ensure broad and equitable availability and access to diagnostics and medicines. And governments at all levels need to work together with industry, NGOs and civil society to make sure that policies don’t have unintended consequences.
HealthyWomen: How should women prepare for future pandemics and what can individuals do to fight the progression of AMR?
Erika Satterwhite: Patients play an important part in fighting the progression of AMR by making educated decisions around treatment and use. Better hygiene as well as vaccination against bacterial pathogens and viral infections also helps with preventing infection in the first place. And we know women are important in this fight as we often serve as the healthcare decision-makers and reinforcers of health and wellness inside and outside of our homes.
This resource was created with support from Viatris.