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Working against pathogenic microbes in a globalised world is a matter of self-interest at least as much as a responsibility to our neighbours. Antimicrobial resistance (AMR) is responsible for an estimated 700 000 deaths annually worldwide. The review1 on AMR, commissioned by the British Government and chaired by Jim O’Neill, estimates that, if current trends continue, annual fatalities from drug-resistant microbes could rise to more than 10 million by 2050, exceeding deaths caused by cancer. The European Union (EU) has been committed to combating AMR since 1999, and has continued to prioritise research on AMR in its Horizon 2020 research programme. As part of this commitment, the EU has spent more than €1 billion on AMR research, developed a 12-point action plan on AMR, and launched the Joint Programming Initiative on AMR (JPIAMR), which aims to increase the coordination of AMR research worldwide. After Japan and Argentina joined in 2015, JPIAMR now has 22 members, 12 of which have a national AMR strategy, a marked improvement since 2011, when none of these countries had an action plan on AMR.2 A major achievement of the EU has been the inception of the world’s biggest public–private partnership in the field of AMR: the New Drugs for Bad Bugs (ND4BB) programme. This programme was launched under the Innovative Medicines Initiative in 2012, and has contributed to increasing the number of large European pharmaceutical companies active in the research area from four to 11 in the past 5 years. As part of the ND4BB programme, €650 million have been invested across seven projects ranging from basic science to drug discovery, and the development www.thelancet.com Vol 388 August 27, 2016
of new business models.3 Through calls-for-research specifically targeted at small and medium sized enterprises (SMEs), the European Commission has also strengthened European SMEs involved in AMRrelated research. In the past decade, the number of SMEs working on AMR in the Biopharmaceutical companies from Europe innovating in AntiMicrobial resistance (BEAM) Alliance increased from just a few to around 50. 4 Furthermore, the European Investment Bank, in cooperation with the Commission, developed INNOVFIN Infectious Diseases, a new financing initiative expected to bring new and innovative players to AMR research.5 However, once new antimicrobials are developed, they still need to be used appropriately to safeguard their effectiveness for future generations, which underscores the importance of developing better diagnostics. In 2015, the European Commission launched a €1 million challenge prize to develop a rapid diagnostic test for upper respiratory tract infections that can be safely treated without antibiotics.6 Moreover, projects funded by previous EU research programmes are now delivering results. For instance, an antibacterial coating gel that prevents infections after surgical procedures,7 or the world’s first clinical trial on phage therapy, a potential alternative to antibiotics. Another example is a network of more than 700 hospitals and 500 laboratories, which forms the basis for the efficient and cost-effective clinical evaluation of drugs and alternative interventions. Through these investments in innovation, the EU has contributed to creating the momentum that has brought pharmaceutical companies— both large and small—back to researching antimicrobials. And, more importantly, these investments are starting to have a real impact in terms of new therapeutics and diagnostics. This positive momentum now needs to be sustained. We declare no competing interests.
*Line Matthiessen, Richard Bergström, Shiva Dustdar, Pierre Meulien, Ruxandra Draghia-Akli
[email protected] Fighting Infectious Diseases and Advancing Public Health Unit (LM), and Health Directorate (RD-A), Directorate-General Research & Innovation, European Commission, B1049 Brussels, Belgium; European Federation of Pharmaceutical Industries and Associations, Brussels, Belgium (RB); Research, Development, Innovation Finance Advisory Division, European Investment Bank, Luxembourg, Luxembourg (SD); and Innovative Medicines Initiative, Brussels, Belgium (PM) 1
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O’Neill J. Tackling drug-resistant infections globally: final report and recommendations. The review on antimicrobial resistance. May, 2016. http://amr-review.org/sites/ default/files/160525_Final%20paper_ with%20cover.pdf (accessed Aug 8, 2016). European Commission. Progress report on the action plan against the rising threats from antimicrobial resistance. Brussels: European Commission, 2015. http://ec.europa.eu/ health/antimicrobial_resistance/docs/2015_ amr_progress_report_en.pdf (accessed Aug 8, 2016). Innovative Medicines Initiative. ND4BB– New Drugs For Bad Bugs. 2016. http://www.imi.europa.eu/content/nd4bb (accessed July 4, 2016). BEAM Alliance. Key actions to reinvigorate investment and R&D. 2015. https://beamalliance.eu/assets/2015-Position-Paper.pdf (accessed July 4, 2016). European Investment Bank. InnovFin Infectious Diseases. 2016. http://www.eib.org/ products/blending/innovfin/products/ infectious-diseases.htm (accessed July 4, 2016). European Commission. Better use of antibiotics–€1 million. http://ec.europa.eu/ research/horizonprize/index.cfm?prize=betteruse-antibiotics (accessed July 4, 2016). European Commission. Bacteria-proof resorbable implant coating for orthopaedics. http://cordis.europa.eu/result/rcn/151250_ en.html (accessed July 4, 2016).
Scientific Panel for Health: better research for better health Health is a human right, with research underpinning every advance in health care. Even if political Europe is under siege, health research must remain high on the agenda of all stakeholders. The Scientific Panel for Health,1 created under the Horizon 2020 Framework Programme for Research and Innovation of the EU, was born out of concerns of the European
Science Photo Library
Increased momentum in antimicrobial resistance research
For more on the Joint Programming Initiative on Antimicrobial Resistance see http://www.jpiamr.eu/
For more on the world’s first clinical trial on phage therapy see http://www.phagoburn.eu/ For more on Combatting Bacterial Resistance EuropeNetworks see https://www. combacte.com/combacte-net/
Submissions should be made via our electronic submission system at http://ees.elsevier.com/ thelancet/
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biomedical research community. 2,3 Too often, high-quality research is not translated into innovation. European strengths and values are not embedded in or supported by research policies. Challenges in regulations and research management accumulate to the detriment of research outcomes, limiting their impact on health. As a science-led expert group with broad vision and stakeholders’ representation, the Scientific Panel for Health has been mandated to provide a comprehensive view on how to advance biomedical research in support of improving health in Europe, and to formulate recommendations to policy makers.1 In May, 2016, the Scientific Panel for Health published a position paper,4 calling for research policies to facilitate high-quality, crossborder collaboration within Europe and beyond; ensure a harmonised, simplified, and transparent regulatory framework that supports innovation; nurture multi-stakeholder, multidisciplinary research across the innovation cycle, identifying common goals; involve citizens and patients; and create value through health in a knowledge-based society. Support of the best research should be guided by a number of principles that enable and leverage: creative and innovative research, generating big and disruptive ideas; collaborative research that adds value to existing programmes; transdisciplinary research (eg, medical technologies, big data, machine learning, health literacy and medical insights, community projects, and technology development). Priorities should be based on health needs (eg, preparing for emerging epidemics), and on opportunities created by new discoveries and innovative technologies (eg, with information and communications technology). Translation and implementation into clinical practice and public health strategies requires evaluation through health and health-care innovation outcomes research. 866
Health care, communication, and research are highly interdependent. Health and research policies should stimulate connected, digital health-care solutions, which drive inclusive and sustainable health. A next generation workforce (workforce 2.0) is needed, which is skilled and trained in new research strategies and innovative entrepreneurship and is able to implement and to evaluate novel health-care solutions. At the first Scientific Panel for Health Forum held in January, 2016, over 400 participants from all EU Member States, representing over 200 governmental, non-governmental, and private research organisations, as well as civil society, discussed the active and flourishing health and biomedical research landscape in Europe, agreeing that more needs to be done to ensure better research leads to better health across Europe. Leadership is needed to tackle issues effectively and focus on outcomes. Supported by the European research community, the Scientific Panel for Health is calling for the development of a comprehensive policy for health research, defining and aligning common projects across European Commission directorates, the EU, and EU Member States; and for the implementation of Health in All policies. A long-term mechanism to ensure implementation of these policies and quality of research requires a science-led multi-stakeholders’ platform for European transdisciplinary health and biomedical research, which could take shape as a European Health Research Council or a European Institute for Health. The dialogue is open. KS, LD, DG, HH, IH, MM, WO, and TZ report non-financial support from the European Commission during the conduct of this study. RF reports non-financial support from the European Commission and Science Europe during the conduct of this study, and personal fees and non-financial support from INSERM outside the submitted work. FL declares no competing interests.
*Karin Sipido, Laurent Degos, Richard Frackowiak, Detlev Ganten, Hans Hofstraat, Ildiko Horvath, Frank Luyten, Michael Manns, Wolfgang Oertel, Tomáš Zima
[email protected] Department of Cardiovascular Sciences, Division of Experimental Cardiology (KS), and Skeletal Biology and Engineering Research Centre (FL), KU Leuven, B3000 Leuven, Belgium; University Institute for Haematology, University of Paris Diderot, Hospital Saint Louis, Paris, France (LD); Department of Clinical Neurosciences, CHUV University Hospital, University of Lausanne, Lausanne, Switzerland (RF); World Health Summit, Berlin, Germany (DG); Philips Research, Eindhoven, Netherlands (HH); National Koranyi Institute for TB and Pulmonology, Budapest, Hungary (IH); University Hospitals UZ Leuven, Leuven, Belgium (FL); Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany (MM); Department of Neurology, Philipps University, Marburg, Germany (WO); and Charles University in Prague, Prague, Czech Republic (TZ) 1
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European Commission. Scientific Panel for Health (SPH). https://ec.europa.eu/ programmes/horizon2020/en/h2020-section/ scientific-panel-health-sph (accessed June 6, 2016). Celis JE, Gago JM. Shaping science policy in Europe. Mol Oncol 2014; 8: 447–57. Alliance for Biomedical Research in Europe. European Council for Health Research Concept Paper. 2012. http://www.biomedeurope.org/ news-press.html (accessed June 6, 2016). Better research for Better Health: A vision for health and biomedical research from the Scientific Panel for Health. May, 2016. https://ec.europa.eu/programmes/ horizon2020/sites/horizon2020/files/SPH_ VisionPaper_02062016.pdf (accessed June 6, 2016).
Transparency and availability of data for cancer research Open research data allows for verification, replication, scrutiny, and subsequent analyses of published studies, while reducing likelihood of research duplication. By contrast, failing to publish data, which is a key impediment in the fight against cancer and non-communicable disease epidemics, hinders timely and effective response t o these challenges.1 Hence, data should be liberated and made widely available to researchers.1 www.thelancet.com Vol 388 August 27, 2016
