Waiting for the next pandemic (not from viruses, but from antibiotic resistance) – breaking latest news

A new pandemic could come, caused by the so-called “resistance to antimicrobials“(In acronym Amr: anti-microbial resistance): antibiotics first of all, that is drugs against bacteria, but also antivirals, intended to fight viruses, and anti-fungals whose goal is to destroy fungi, but we could also add anti-tuberculosis drugs, why tuberculosis is far from under control, especially in emerging countries. In other words: in the face of even the most common infections, the drugs available today are less and less effective and leave them the “license to kill”.

The WHO alarm

This is not an unjustified alarm and the World Health Organization has long raised the issue. And to this theme he dedicates the week from 13 to 19 November (World antimicrobial awareness week) which sees the highlight in Europe on November 18 with theEuropean antibiotic awareness day for the correct use of these drugs. Here are some data to get a dimension of the problem. Today the Amr is responsible, every year, for about 700 thousand deaths worldwide: 33 thousand in the European Union (of which just under a third in Italy) which could reach, in the absence of effective law enforcement actions, 10 million in 2050, which is more than deaths from cancer, diabetes and traffic accidents. In addition to deaths, Italy, among the OECD countries (Organization for Economic Cooperation and Development), also holds the negative record, in terms of Dalys (Dalys is a parameter that evaluates the years of life lost due to a specific disease or lived with disabilities): it is estimated that, in 2050, up to one in 105 people could lose a year of healthy life because of the Amr.

Planetary health

All this was discussed in a conference in Rome entitled “Planetary health and Amr”, organized by European House – Ambrosetti, which emphasized two themes in particular. The first: how, from now on, any health intervention involving humans (including the fight against AMR), cannot ignore the vision “one healthThat is, by taking into account the health of humans and animals at the same time. But it must go further, in a broader perspective: that of “planetary health“(Definition coined in 2105 by the American Rockefeller Foundation and by the English magazine Lancet) which wants to take into consideration not only man and animals, but also their relationship with the environment. Today we know that many diseases, and not just infectious ones, derive from an altered balance between man-animals-
environment. To say, bats infected with the Ebola virus of hemorrhagic fever, which causes clearing of forests in some areas of Africa, have arrived in villages and cities, infecting humans. Second: how, also thanks to the Covid experience, can this new challenge be faced?

Environmental pollution

Comment Paolo Vineis, professor of environmental epidemiology at the Imperial College of London and visiting professor at the Italian Institute of Technology in Genoa, on the first point: “The commercial flows of products, from developing countries to rich ones, have an environmental impact and contribute to the spread of infectious diseases. Not only that, but also of environmental pollution which in turn is responsible for other diseases, such as respiratory diseases ». He adds Gianni Rezza, general manager at the Ministry of Health on the second point: “In 2017 Italy was the black jersey of antibiotic resistance in Europe. Then a plan to combat this phenomenon and campaigns against the abuse of antibiotics were launched. Now we are continuing with these policies with some success and the PNRR (the National Recovery and Resilience Plan) will provide one more opportunity ». Combined with the experience gained in the Covid emergency. But what are they the strategies to be implemented to stem this problem? The first is to inform health professionals and the public about the rational use of these drugs. And on this, in fact, the institutions are called to play.

Public-private collaboration

The second is to stimulate the pharmaceutical industry to invest in search for new antibiotics (research left a little aside in recent years because it was considered unprofitable) also in the increasingly stringent perspective, in the field of health, of collaboration between public and private sectors. Comment Paivi Kerkola, CEO of Pfizer Italia, the industry that made the anti-Covid vaccine based on the innovative mRna technology available: «We must learn from the lesson of the pandemic. Problems can only be solved with a partnership between the various health care players ”. AND Pfizer is one of the companies that is investing in the search for new drugs to combat AMR.

Quick tests

The third is that of perfect diagnostic tools to intervene immediately, when an infection is suspected. Always with a view to a rational use of antibiotics. «Today – he comments Statis Chorianopoulos, vice president of the Adriatic Cluster of bioMérieux – to get the result of an antibiogram, that is to understand which is the best antibiotic to fight a particular infection, it takes 72 hours. Today we must also fight against time: it is necessary to have rapid tests that, in an hour, can give indications on the drug to choose. In order not to run the risk of using the wrong antibiotics, not to waste resources and not to favor, with the indiscriminate use of these drugs in an inappropriate way, the onset of resistance. And last but not least, to limit costs ». The formula, useful for fighting AMR, should be: the best antibiotic, to the right patient, in the right time. Anti-infective therapy must also be personalized.