Antimicrobial resistance (AMR) is a looming crisis and potentially “even larger than the COVID-19” pandemic, the CEO of one of the few remaining antibiotic producers with a manufacturing presence in the EU told EURACTIV in an interview.
Rex Clements, the chief executive of Centrient, said one fundamental step to prevent this crisis is to recognise the value of antibiotics.
“Something is wrong when a pack of antibiotics costs the same as a pack of chewing gum. These are life-saving medicines, but we need to use them appropriately in order to prevent resistance. We all have a role to play, and I hope that the EU plays its part,” he warned.
The World Antimicrobial Awareness Week takes place on 18-24 November, aiming to raise awareness around the proper use of antibiotics to avoid the spread of drug-resistant infections.
AMR occurs when microbes such as fungi, viruses, parasites and bacteria develop resistance to one or more antimicrobial drugs.
In the EU, 33,000 people die each year due to infections caused by resistant bacteria, according to European Commission data.
How to avoid shortages
In light of a new EU Pharmaceutical Strategy due to be presented soon, the antibiotics industry says there are very few antibiotic manufacturers left in Europe and this causes problems because of possible shortages.
“We all want to prevent shortages and ensure resilient supply chains. This is fundamental to the way we do our business – in Europe, and around the world,” Clements said.
A significant percentage of active pharmaceutical ingredient (API) production nowadays is based in India and China, he added.
“Yet Centrient is one of the few antibiotic producers with manufacturing still in Europe. We have sites in both the Netherlands and Spain – in Delft and Barcelona.”
He called on the EU to boost its competitiveness as a place to manufacture antibiotics following specific steps.
“First, to introduce appropriate incentives for EU-based production; second, to apply procurement criteria that take into account supply chain sustainability and security; and third, to support green manufacturing, and strengthen the EU’s role to promote this on a global stage.”
He warned, though, that the overconcentration of supply in one region would do more harm than good.
“Imagine if every company did massively bring production back to Europe. We would all be at far greater risk if some crisis – COVID or any other – were then to hit that supply,” he said, adding that what really prevents shortages is having sustainable and diversified supply chains.
“In order to maintain supply in Europe and around the rest of the world, we’ve had our plants in Latin America and Asia running at full capacity – as well as our sites in Europe,” he said.
The Green transition challenge
As part of the EU Green Deal, the Commission has proposed measures to address pollution from urban runoff and from new or particularly harmful sources of pollution such as micro plastics and chemicals, including pharmaceuticals.
For Clements, this is hugely relevant for preventing AMR.
“If manufacturing effluents aren’t adequately treated to remove antibiotic residue, these chemicals eventually reach the environment and water bodies, through wastewater streams, creating ‘hotspots’ for development of resistant bacteria nearby,” he said.
He said the pharma industry has already taken some steps. His company has been cleaning and monitoring since 2016 antimicrobial activities in wastewater at all its sites.
He added though that the same high quality and environmental standards should apply across the globe.
“The EU could do more to bring countries like China and India along with it on the green transition. This would help to drive Europe’s competitiveness, and set a level playing field between the EU and third countries – so also encouraging companies to invest in Europe and set up manufacturing here,” he concluded.
[Edited by Zoran Radosavljevic]