Superbugs should be entered as a cause of death on death certificates, say experts

Antibiotic resistance should be listed as a cause of death on official certificates, one of Britain’s leading experts on superbugs has said.

Lord Jim O’Neill, a former Goldman Sachs economist and chair of the Chatham House think tank, told a conference in London – also attended by former Chief Medical Officer Dame Sally Davies – that the move would help raise awareness of the growing superbug crisis.

In 2016, Lord O’Neill led a major government review into antimicrobial resistance (AMR), which called for a complete overhaul of the global antibiotics market and predicted that 10 million people could die each year from drug-resistant infections unless urgent action is taken.

On Thursday, he added that including AMR on death certificates would help focus attention on the emerging crisis and improve the data scientists have to work with.

“The case for having death certificates to include AMR as a cause of death is quite compelling,” Lord O’Neill said.

He also warned that since 2016, the number of AMR-related deaths in Europe has increased from an estimated 25,000 a year to 37,000 – a faster rate than was previously predicted.

Last week, the Centre for Disease Control in the US released new figures which suggest that drug-resistant superbugs are a much larger public health threat than previously thought – killing some 35,000 Americans a year and infecting roughly 2.8 million.

And in Canada, a report by the Council of Canadian Academies found that drug resistant bugs already account for 26 per cent of all infections treated in the country, causing an average of 14 deaths a day.

“Modern medicine is at stake,” Dame Sally Davies told the event at the European Bank for Reconstruction and Development in London, “we’ve got a global problem.”

The former Chief Medical Officer, now Master of Trinity College Cambridge and a special envoy on AMR for the UK government, said that she was disappointed by a lack of action since the landmark 2016 report.

In particular, she said that the lack of new antibiotics being developed represented a “market failure” – large pharmaceutical companies are quitting the antibiotic industry because it is not lucrative enough.

“The big companies have been hollowing out their pipeline and... abandoning pre-clinical and clinical research and development, leaving it to small companies,” said Dame Sally.

“Of 39 companies with antibiotics in clinical development, only three rank among the top 50 pharmaceutical companies by sales, and over 90 per cent of products in development are being studied by small companies.

“It’s a pretty sparse pipeline and I would argue we’re approaching the cliff edge,” she added.

But Dame Sally said that it was shortsighted of “big pharma” because many of the treatments for diseases including cystic fibrosis and cancer are supplemented by antibiotics.

“What I don’t understand about these drug companies, and I keep saying to them, is that if you want us to buy your very expensive cancer therapies – which cause immune deficiencies so patients get infections – you need antibiotics.

“So why are you not protecting your product line?” she said.

In the 2016 AMR review, it was predicted that inaction would cost the global economy around $1 trillion a year by 2050 – but just $40 billion of investment is needed over the next decade to begin to turn to table on superbugs.

The original report made 27 recommendations, but Lord O’Neill said on Thursday that as well as listing AMR on relevant death certificates, he would now also suggest that the International Monetary Fund ranks countries on health preparedness to stimulate investment in new antibiotics.

“The only way of really getting countries that aren’t investing properly in these things to do it is for them to feel the risk that they’re going to be downgraded my the IMF, or by rating agencies linked to IMF reports,” he said.

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