October 04, 2010
On Friday the National Institutes of Health (NIH) hosted a public meeting of TATFAR, or the Trans Atlantic Task Force on Antimicrobial Resistance. I attended, interested to observe this stakeholder discussion of antibiotic resistance and policies to alleviate the problem. The good news is that there seems to be a strong appreciation that we need both new drug development AND strategies to conserve our antibiotics. There is also an awareness that these strategies can be at odds with one another i.e. that conservation cuts into drug sales, which discourages pharmaceutical investment in new drugs (see discussion of the cross-incentive problem here). Merging those two goals presents some unique challenges, particularly when working across national borders.
TATFAR was established following an EU-US Summit Declaration in November 2009 that called for a transatlantic task force on urgent antimicrobial resistance issues focused on appropriate therapeutic use of antimicrobial drugs in the medical and veterinary communities, prevention of both healthcare- and community-associated drug-resistant infections, and strategies for improving the pipeline of new antimicrobial drugs, which could be better addressed by intensified cooperation between us. Specifically, the task force focuses on increasing mutual understanding of the problem of resistance, deepening transatlantic dialogue around the issue, and promoting information exchange. The task force’s 18 members (drawn from the US federal government and the EU civil service) are divided into three working groups designed around the goals of the Declaration encouraging appropriate use, improving infection prevention, and developing the pipeline for new drugs. The end result will be a report for US and EU leadership, expected to be completed in the spring of 2011.
The NIH meeting offered an opportunity for stakeholders to present their concerns to the TATFAR committee, so there was little indication of the specific shape of the final TATFAR report. The constraint of TATFAR is its lack of enforceable authority the task force is limited to making recommendations. Ensuring that policymakers follow through on these recommendations is virtually impossible; nevertheless TATFAR does represent an opportunity to deepen transatlantic dialogue on what is certainly a global issue. And its creation is particularly timely given that World Health Day 2011 has been dedicated to the issue of antimicrobial resistance.
As an appropriate close to public comments, Rachel Nugent of the Center for Global Development gave a thoughtful and innovative assessment of possibilities for collaboration beyond even US and EU boundaries. Her comments were based on the Center for Global Development’s June 2010 report (which covers drug resistance including and beyond the antimicrobial variety, worth a read in its entirety). As Dr. Nugent pointed out, antibiotic use anywhere speeds the development of resistance around the world as this summer s coverage of the resistance-producing NDM-1 gene demonstrated, thinking about global collaboration is a must. There is a tremendous need to pool resources on this issue, share information, and facilitate coordinated responses. The hope is that a group like TATFAR can begin to lead the way both in crafting innovative policy recommendations and in acting as a model for international dialogue on the issue.
Photo credit: Flickr: The Life of Bryan
