Global leaders disappoint with their plan to fight superbugs

Global leaders presented their answer to one of the biggest health threats facing humans on Thursday — and it failed to deliver.
Antimicrobial resistance (AMR), which occurs when bacteria, fungi or viruses become resistant to drugs, kills more than 1 million people each year, with that figure set to rise as high as 1.91 million a year by 2050.
Thursday’s meeting of governments at the United Nations General Assembly in New York was the first high-level meeting on AMR since 2016. Experts had hoped that the resulting agreement, months in negotiation, would be an ambitious rallying call, full of commitments to end widespread antibiotic misuse, promote new drug discovery and guarantee equitable access.
But the final 15-page declaration is a disappointment to experts and health NGOs. The “boldness and assertiveness” of the 2016 declaration on AMR are gone, and while there is consensus over the scale of the crisis, there is no clear agreement on how to prevent it, Jaume Vidal, senior policy advisor at Health Action International, told POLITICO.
Drug resistance threatens to reverse many of the advances in medicine over the past century. Routine infections could become much harder to treat, and everyday surgeries could be more dangerous. In a worst-case scenario, the world risks reverting to the pre-penicillin era.
On Thursday, leaders agreed to establish a new independent panel to produce scientific evidence on AMR, raise $100m for developing countries, and strive to reduce antibiotic use in farming.
They will also aim to reduce the estimated 4.95 million direct and indirect human deaths associated with bacterial AMR annually by 10 percent by 2030.
Given the scale of the problem, the document “should have been much more concrete and ambitious,” Christos Christou, international president of Doctors Without Borders, said in a statement ahead of the meeting.
Any hopes the declaration would significantly change the status quo dissipated as successive, weaker drafts emerged from the fractious talks, Vidal told POLITICO.
Negotiations were marked by divisions over financing, obligations on the pharmaceutical and agricultural industries, the sharing of new technology, and equitable access to new drugs.
One of the most watered-down areas was curbs on rampant antibiotic use in farming, one of the biggest drivers of AMR. 
An earlier draft committed to a 30 percent cut in usage by 2030, and an end to the use of the most essential antibiotics in animals altogether. But according to the final draft, countries will “strive to meaningfully reduce, by 2030, the quantity of antimicrobials used globally in the agri-food system from the current level, taking into account national contexts …”
One of the biggest underlying problems is that the pharmaceutical industry isn’t coming up with new antibiotics. The reason is that it’s expensive, high-risk work that may not deliver significant financial returns — not the kind of thing investors typically go for.
Antibiotics, in general, are more powerful the less they are used, while new ones are supposed to be saved as a last resort, limiting their commercial appeal.
Pharma companies want governments to introduce industry incentives to make the numbers on new antibiotic development add up, James Anderson, chair of the AMR Industry Alliance, told POLITICO.
The EU hopes to use proposed new pharmaceutical legislation to incentivize the development of new antibiotics, using vouchers that would give drug companies extra years of monopoly on a product of their choice.
The declaration has also raised questions over who would have access to any new antibiotics that are developed. NGOs such as the Third World Network are alarmed at the weak language on the sharing of technology and know-how in the declaration, which aims to promote “voluntary licensing” when public money is invested into the development of new drugs.