The increasing number of bacterial infections globally that do not respond to any available antibiotics indicates a need to invest in—and ensure access to—new antibiotics, vaccines, and diagnostics. The traditional model of drug development, which depends on substantial revenues to motivate investment, is no longer economically viable without push and pull incentives. Moreover, drugs developed through these mechanisms are unlikely to be affordable for all patients in need, particularly in low-income and middle-income countries. New, publicly funded models based on public–private partnerships could support investment in antibiotics and novel alternatives, and lower patients' out-of-pocket costs, making drugs more accessible. Cost reductions can be achieved with public goods, such as clinical trial networks and platform-based quality assurance, manufacturing, and product development support. Preserving antibiotic effectiveness relies on accurate and timely diagnosis; however scaling up diagnostics faces technological, economic, and behavioural challenges. New technologies appeared during the COVID-19 pandemic, but there is a need for a deeper understanding of market, physician, and consumer behaviour to improve the use of diagnostics in patient management. Ensuring sustainable access to antibiotics also requires infection prevention. Vaccines offer the potential to prevent infections from drug-resistant pathogens, but funding for vaccine development has been scarce in this context. The High-Level Meeting of the UN General Assembly in 2024 offers an opportunity to rethink how research and development can be reoriented to serve disease management, prevention, patient access, and antibiotic stewardship.

中文翻译：

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扩大抗生素、疫苗和诊断的开发和获取以解决抗菌素耐药性


全球范围内对任何现有抗生素都没有反应的细菌感染数量不断增加，这表明需要投资并确保获得新的抗生素、疫苗和诊断方法。依赖大量收入来刺激投资的传统药物开发模式在没有推拉激励的情况下在经济上不再可行。此外，通过这些机制开发的药物不太可能让所有有需要的患者都能负担得起，特别是在低收入和中等收入国家。基于公私合作伙伴关系的新的公共资助模式可以支持对抗生素和新型替代品的投资，并降低患者的自付费用，使药物更容易获得。可以通过公共产品来降低成本，例如临床试验网络和基于平台的质量保证、制造和产品开发支持。保持抗生素有效性依赖于准确和及时的诊断；然而，扩大诊断规模面临着技术、经济和行为方面的挑战。新技术在 COVID-19 大流行期间出现，但需要更深入地了解市场、医生和消费者行为，以改善诊断在患者管理中的使用。确保可持续获得抗生素还需要预防感染。疫苗具有预防耐药病原体感染的潜力，但在这方面疫苗开发资金一直匮乏。 2024 年联合国大会高级别会议提供了一个机会，让我们重新思考如何调整研发方向，以服务于疾病管理、预防、患者获取和抗生素管理。