The Australian Antimicrobial Resistance Network (AAMRNet) is a multi-stakeholder expert group committed to combating the urgent global threat of antimicrobial resistance (AMR).
AAMRNet is a public-private partnership, established and operated by MTPConnect, the Industry Growth Centre for Australia’s medical technology, biotechnology, pharmaceutical and digital health sector, delivering on a key recommendation of the report Fighting Superbugs: A Report on the Inaugural Meeting of Australia’s Antimicrobial Resistance Stakeholders.
AAMRNet is working with key national and international stakeholders across the biotechnology and pharmaceutical industry, the health and medical sector, clinicians, and government, to identify and tackle the challenges of AMR.
AAMRNet leverages MTPConnect’s networks, resources and its reputation as an independent and trusted voice for the sector, and brings together experts from industry, research, clinicians and government. Through its partnerships and engagement with key national and international stakeholders, AAMRNet is established as the key organisational contact point for access to Australian AMR expertise.
As the only body in Australia able to provide whole-of-sector representation, AAMRNet is uniquely placed to promote Australia’s role in the fight against AMR.
The Urgent Threat of AMR
AMR occurs when microbes such as bacteria and fungi become resistant to the drugs which once killed them - evolving into untreatable ‘superbugs’.
The World Health Organization (WHO) has declared it one of the top ten global public health threats facing humanity and has cautioned that it is possible that a “post-antibiotic era” may be coming, where minor infections – currently easily treated with common antibiotics – may become deadly.
Often described as a ‘silent pandemic’, AMR killed more people than malaria and HIV globally in 2019, when, in Australia, over 1,600 deaths were directly attributable to AMR.
The Review on Antimicrobial Resistance estimates that around 10 million lives per year will be lost globally, and a cumulative US$100 trillion of economic output will be put at risk if no action is taken by 2050. The estimated annual impact of AMR on the Australian economy by 2050 will be between $142 - $283 billion.
AMR is also a serious threat to heath equity, as it disproportionately affects our most vulnerable. The burden of AMR being higher in aged care, women, children, indigenous and remote populations, and people with chronic underlying disease such as diabetes.
Climate change and the COVID-19 pandemic are making the situation worse. Warmer temperatures and more frequent severe weather events promote the spread of drug-resistant infections, and studies have shown an overuse of antibiotics in COVID-19 patients, even when not clinically indicated. In addition, secondary bacterial infection has been linked to significant rates of mortality in COVID-19 patients.
Antimicrobials underpin all of modern medicine, and AMR may also limit future capacity to perform medical procedures where antibiotics are the main line of defence, such as organ transplantation, cancer chemotherapy, diabetes management and major surgery.
Pathogens are constantly evolving, meaning a robust pipeline of new antimicrobials is central to combatting AMR. Yet, despite the urgent need, that pipeline is currently considered insufficient to tackle the rise and rapid spread of AMR.
A key reason for this is the market failure that exists, where it is not financially viable to invest in the development and commercialisation of new antimicrobials. This is causing antibiotic drug developers to face bankruptcy, and most of the large pharmaceutical companies to exit the field altogether.
Currently, reimbursement is linked to sales volumes, but to protect their effectiveness, novel antimicrobials are used sparingly, and only when all other treatments have failed or are inappropriate. They are also generally undervalued by reimbursement systems relative to the benefits they bring to society, resulting in a commercial return not sufficient to meet the costs of research and development, nor the ongoing post marketing costs.
Addressing this market failure requires a critical balance of both ‘push’ incentives, that lower the cost of R&D, and ‘pull’ incentives, that provide a predictable return on investment and reward successful development.
AAMRNet's Strategic Priorities
AAMRNet is advocating for significant investment in two specific areas to help combat the urgent global threat of AMR and ensure Australians have access to the lifesaving, health system enabling medicines they deserve:
- Establish an AMR focused Accelerator in Australia, aiming to be fully integrated into the CARB-X global network, the first of its kind in the Western Pacific Region.
- Rapidly establish a pilot fund for novel antimicrobials in Australia.
A Global Response
The threat of AMR calls for an immediate global health response.
The WHO, in its Global Action Plan on AMR, urged countries to have in place their own national action plans, aligned with its own, to strategically counter AMR.
It highlights the need for improving awareness and communication around AMR, surveillance, infection prevention and antimicrobial stewardship. It also calls for countries to increase investment in new medicines, diagnostic tools and vaccines.
The G7 has acknowledged the importance of ‘pull’ incentives, with the Finance Ministers releasing a statement on ‘Actions to Support Antibiotic Development’ in 2021, calling to strengthen preparedness against AMR.
The statement commits all G7 members “to expedite their implementation of existing strategies… and to take additional specific and appropriate steps to address the antibiotic market failure and create the right economic conditions to preserve essential existing antibiotics and ensure their access, strengthen AMR antibiotic R&D, and bring new drugs to market where they meet identified public health needs”. G7 Health Ministers and Leaders have since reinforced this message.
Several countries around the world are implementing or exploring their own ‘pull’ incentives, including the UK which has undertaken a successful reimbursement pilot which considers additional values that antibiotics provide to society. These values are known as the STEDI Values of Antibiotics and include Spectrum value, Transmission value, Enablement value, Diversity value and Insurance value.
In Australia, the Australian Government House of Representatives Standing Committee on Health, Aged Care and Sport’s recent report, The New Frontier - Delivering better health for all Australians outlined several initiatives, including the need for effective funding and the establishment of a pilot scheme for new antimicrobials.
AAMRNet Position Statement
Through the efforts of its working group on pricing and funding, AAMRNet has developed the 'AAMRNet Position Statement: Pricing and reimbursement of novel antimicrobials in Australia', highlighting innovative strategies for bringing new antibiotic treatments to market.
The statement, released in May 2022, is aimed at stimulating discussion and spurring action.
It canvases ways to stimulate research and development for new treatments, novel reimbursement approaches to support and ensure a continuing pipeline of novel therapies and the merits of a pilot Australian fund to provide access to new antimicrobials and support their appropriate use.
Antimicrobial Resistance Impact Report: How big is Australia's AMR threat?
MTPConnect, through the Australian Antimicrobial Resistance Network (AAMRNet), and the Commonwealth Scientific and
Industrial Research Organisation (CSIRO) combined resources to develop this report to improve current estimates of the mortality burden of AMR in Australia.
'Antimicrobial Resistance (AMR) Impact Report: How big is Australia's AMR threat?' delves deeper into the gaps in our data collection methods to find out how many people are dying from drug-resistant infections in Australia.
The report was launched to coincide with 'World Antimicrobial Awareness Week 2022', a global campaign held annually from 18-24 November. WHO has identified antimicrobial resistance (AMR) as one of the top 10 global public health threats.
AAMRNet is supported by industry contributions from: Pfizer ANZ, CSIRO, MSD Australia, GSK Australia, Recce Pharmaceuticals, Botanix Pharmaceuticals, SpeeDx, Medicines Australia, Tenmile, Biointelect, Monash Centre to Impact AMR, and Bugworks Australia.
Additional partners of the AAMRNet include: AusBiotech, BiomeBank, Community for Open Antimicrobial Drug Discovery (CO-ADD), DMTC, Epichem, Formulytica, GARDP, Incubator for Antibacterial Therapies in Europe (INCATE), LBT Innovations, Menzies School of Health Research, Microbio, Monash Biomedicine Discovery Institute, RESULTS International Australia and Roche Diagnostics Australia.
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- MTPConnect report – Fighting Superbugs: A Report on the Inaugural Meeting of Australia’s Antimicrobial Resistance Stakeholders
- AAMRNet submission to the Standing Committee on Health Aged Care and Sport’s Inquiry into approval processes for new drugs and novel medical technologies in Australia
- Official Committee Hansard – AAMRNet appearance at the Standing Committee on Health Aged Care and Sport’s Inquiry into approval processes for new drugs and novel medical technologies in Australia, public hearing, Melbourne 22 March 2021
- AAMRNet Pre-budget 2023-2024 submission
- AAMRNet Position Statement: Pricing and reimbursement of novel antimicrobials in Australia
- Australia’s National Antimicrobial Resistance Strategy – 2020 and beyond
- CSIRO Minimising Antimicrobial Resistance Mission
- Combating Antibiotic-Resistant. Bacteria Biopharmaceutical Accelerator (CARB-X) - a global non-profit partnership dedicated to accelerating antibacterial research to tackle the global rising threat of drug-resistant bacteria
- Global Antibiotic Research and Development Partnership (GARDP) - a not-for-profit organisation developing new treatments for drug-resistant infections that pose the greatest threat to health
- AMR Action Fund – Created by leading pharmaceutical companies, the AMR Action Fund aims to bring 2-4 new antibiotics to patients by 2030.
- Interdisciplinary Course on Antibiotics and Resistance (ICARe) – Held yearly in Annecy, France, ICARe is designed to bring leaders in academics and industry together with early career trained scientists to examine cutting-edge approaches for the study of resistance.
- Incubator for Antibacterial Therapies in Europe (INCATE) – a not-for-profit organisation that brings together translational and basic research, industry, experienced entrepreneurs and investors from across Europe.
- REPAIR Impact Fund – established by Novo Holdings, the Replenishing and Enabling the Pipeline for Anti-Infective Resistance (REPAIR) Impact Fund’s philosophy is to support ambitious programmes addressing antimicrobial resistance through a broad range of therapeutic modalities.
- World Antimicrobial Awareness Week - Ep 141: Bugworks Tackles the Superbug Challenge
- Ep 114: CO-ADD Sparks Up the Hunt for New Antibiotics
- Ep 115: LBT Innovations' Technology Aims to Speed Up Detection of Antimicrobial Resistance
- Ep 116: Recce Scouts New Synthetic Anti-Infectives to Overcome Resistance
- Ep 117: BiomeBank Develops Pioneering Microbiome Treatments
- World Antimicrobial Awareness Week - Ep 85: OUTBREAK Report On Superbugs
- EP 76: Launching Australia's first Antimicrobial Resistance Network & the Fighting Superbugs report
- EP 48: Australia's Position to Tackle Antimicrobial Resistance
- EP 46: Tackling a Global Health Challenge in Antimicrobial Resistance
On the final day of World Antimicrobial Awareness Week 2021 (WAAW) the AMRelay 2021 took place - a 24-hour virtual and global event organised by the AMR Insights Ambassador Network - offering a series of consecutive contributions from stakeholders in the AMR sector. AAMRNet Co-Chair Andrew Bowskill presented an update on Australia's first industry-led, multi-stakeholder Antimicrobial Resistance Network, established and operated by MTPConnect to support actions to combat AMR in Australia. Watch the video below: