The way forward
Deciphering human and microbial genomes is currently being accomplished at an unprecedented pace. The key to success in the fight against antibiotic resistance lies in establishing an integrated approach that can also exploit new opportunities offered in genomic research. These opportunities are being further emphasised and explored in new research projects in the Sixth Framework Programme (2002-2006).
The new strategy will address:
- New classes of anti-infective drugs
Virtually no new classes of antibiotics have been discovered in recent years. At present, the average cost of developing a new drug is around €500 million, and industrial incentives seem insufficient to overcome this barrier fast enough to secure continued access to effective anti-infective drugs.
Exploitation of genomics is likely to yield new generations of drugs faster and more cheaply.
- Diagnostic tests
Prudent prescribing of appropriate antibiotics is best achieved if doctors have access to quick and inexpensive diagnostic tests to identify pathogens and their resistance properties. Modern DNA technology is essential to accelerate the development of new and refined tests and, once available, it is crucial to ensure that appropriate incentives are created for their use.
- Vaccine development
Infection control through vaccination is an indirect but very powerful and cost-effective way to reduce the need for antibiotics in the first place. Genomics offers a new and promising route to vaccine development.
Epidemiological surveillance of antibiotic resistance in human and animal pathogens is an essential component in the strategy. Antibiotic consumption must be monitored and linked to both resistance data and clinical outcomes.
- A multi-faceted problem
The problem of antibiotic resistance is truly multi-faceted and brings with it wide-ranging socio-economic and political consequences. It addresses many aspects of the social and health economy, such as prescribing behaviour and education of doctors, medical reimbursement, and public expectations. It also reaches beyond human medicine into animal health, farming and food industries, and environmental issues. For the new approach to be successful, this broad range of factors must be taken into account.