My talk today was mainly about new initiatives that we are launching with WHO with the strategic input of CHAI and UNICEF which is called SECURE, an antibiotic facility. The mission of this initiative is really to expand access or accelerate access of essential antibiotics in the countries in need in order to manage the emergence of drug-resistant bacterial infection.
Can you tell us about SECURE?
As I said, SECURE, it’s an initiative and its objective is to find a way to accelerate access to essential antibiotics. In fact, we have a huge problem regarding access of antibiotics worldwide and especially in LMICs, low- and middle-income countries. When I am talking about antibiotics that means generic products such as penicillin, for example, because such product is not available in all the different countries and you have a lot of shortages issues regarding this kind of product. But also new antibiotics in order to manage drug resistant bacterial infection and such products are not available in all countries. In fact, they are only available in some countries in the US and Europe.
So the objective and the mission of SECURE is really to find a way to tackle all the different barriers to access and we need to ensure that all the countries in need will have access to a pot full of essential antibiotics.
What are some of the challenges to expanding access to essential antibiotics for cancer patients in some countries?
In fact there are a lot of different barriers when we are looking at access to antibiotics. There are some barriers linked to, I would say, the optimal use and clinical data. We don’t have a lot of information, clinical data or evidence, in order to understand how to use such products. So you will be in the situation where some countries’ physicians don’t know how to use such products because they don’t have any data.
In parallel there are no market links to these kinds of products. The market is quite small and unpredictable because in some countries you don’t have data so you don’t know how to assess the situation, you don’t know how to assess the burden. In parallel people are not choosing such products. So that’s why it’s a low volume product although I would say it’s becoming very difficult for the different companies to do something on that.
The issue of getting the supply, how to ensure the product will be available at the country level so you need to build all the supply chain. But if the market is not attractive how to motivate the different manufacturers to be active on this question? Linked to that, I would say, all the questions of getting registration – how to ensure the product will be registered at the country level because it’s expensive to do that and the different manufacturers don’t want to spend the money and the time to do these kinds of activities.
So we have an issue regarding evidence, regarding distribution, regarding registration but also we don’t have any clear access plan at the country level and we don’t have any funding in order to do that. So that’s why there is a lot of different barriers in order, really, to increase and to expand access to antibiotics in a lot of different countries. I am talking not only about low- and middle-income countries; in countries such as Japan, for example, it takes more than five years for Japan to have access to new products. The same situation in other countries like the Nordic countries in Europe or Canada. So that’s why what we are doing could be quite interesting for a lot of different countries.
How can some of these challenges be overcome?
On SECURE what we have done so far was first to clarify what we want to do. So we need to move from a concept to a project. But also, linked to that, just to ensure that everybody is aware we’re getting this kind of initiative. So we spent a lot of time to make some socialisation of SECURE, discussing with the civil societies but also discussing with all the different industry players because they are the owners of the products at the end of the day. But also with the different governments from the G7, G20, but also at the country level.
One of the main achievements was to be on the G7 Health Ministers’ declaration last year and this year but also in order that we need to launch this kind of initiative what do we need? It’s some funding. So one of our main objectives was we need to develop a fundraising plan and we were quite happy to announce yesterday during the World Health Summit that we raised some money from the Wellcome Trust and from Canada in order to help us to start working on this project and really to define what should be the modus operandi of SECURE. So that’s where we are right now.
We also launched a website within SECURE and what we plan to do right now is really to continue to work on the project and really to enter into this kind of development phase before launching the project in different countries. Our goal is by 2023, 2024 to launch SECURE in at least four participating countries, really just to test and to fine tune what we want to do before moving to a full scale-up of the project.
Anything else to add?
The objective of SECURE is really to find a way for LMICs to have access to the product. I joined GARDP five years ago and I didn’t realise the complexity of where we are living right now, linked to the emergence of resistance. In fact, each time we are talking about access we are talking about stewardship so it means to ensure that a product will be accessible but in parallel to ensure that the product will be used appropriately. That’s all the complexity of that because we are trying to find a way to bring products to different countries but just to ensure in parallel that the product will be used appropriately. So it means the volume will be quite low. In parallel we are just expecting that different people will take the lead in order that we need to develop some new antibiotic treatments, in order we need to fight the emergence of resistance. So that’s why an organisation like GARDP, Global Antibiotic Research and Development Partnership, is here as a not for profit organisation in order really to develop new antibiotic treatments but also ensuring access of this antibiotic treatment in the different countries it needs.
Are there any training programmes to prevent antibiotics being overprescribed?
We are brainstorming right now to develop this kind of programme. Yesterday I saw regarding Oxford University having this kind postgraduate global public health programme online. Their objective is really to make this kind of information and twinning regarding appropriate use of the different products, the different antibiotics.
In parallel within GARDP we have this kind of REVIVE platform in order really to do a lot of communication on what’s going on in antibiotics and why it’s so important to use them appropriately. So maybe looking at the REVIVE platform could be of huge value for your audience.