AMR (anti-microbial resistance) is a world health issue. Many believe there cannot be too much investment in and coordination globally on this issue. Standards and regulation – across the use by humans and animals of antibiotics and antifungals – are one thing; but are they the only way forward?

The extensive use of antibiotics in animal feed (to avoid mass infection and for growth) is an important point. Through the food chain, humans have become resistant to these drugs with alarming consequences. Our soil, water courses and oceans are already impacted. Farming practices will have to change if we are to tackle AMR over the long term.

Investors are warning of ecosystem collapse

It is hard to overstate the problem and investors are already sounding the alarm. At the end of 2024, investors representing more than $13tr in combined assets petitioned policymakers to intervene on the use of antibiotics in the food value chain. This world health issue is an economic crisis in the making.

AMR is up there with climate change when it comes to resilience at both the corporate level and at the world economy level – and everything in between. Once again, investors have a role to play in championing long-termism over short-term financial gain and have the appetite to act.

Ahead of the UN General Assembly’s second high-level meeting on AMR in September 2024, 80 investors backed a statement from Investor Action on Antimicrobial Resistance. It pointed out that AMR-related treatments and productivity losses could cost $412bn and $443bn respectively per year by 2035.

Putting numbers against the issue is focusing the minds of policymakers. But whether action should be about bringing more drugs to market and potentially adding to the problem, or whether we need to revolutionise attitudes to treatment, remains to be seen.

Drugmakers are being incentivised to act

In the UK, the Government is incentivising the pharma sector to bring new antibiotics to market, using fixed fees. New antibiotics have been a rare occurrence since the 1980s, although there has been a recent flurry of action on that front. Most recently, the EU approved a new antibiotic for serious illness, and there are promising trials for others.

There is a lucrative market in using antifungals as pesticides in agriculture. But developing new antibiotics is not a lucrative business because they are not used over the long term like statins. This is why the UK Government’s initiative is so important.

Governments and the pharma sector are having to think much more imaginatively when reimagining business and health of the future, and we are seeing the first stages of that new thinking.

Compounding crises

Perhaps the word ‘polycrisis’ is a bit dated. It was flogged to death during the pandemic and continued to be so during the war-related energy crisis and cost of living crisis that followed. Now we are starting to think about the compound impact of crises and their interrelationships.

Climate change – a global crisis – is exacerbating all of these crises. For example, rising temperatures are helping proliferate fungi, causing it to spread into the northern hemisphere and threatening millions of lives.

To be blunt, where lives are at risk, so are economies. Covid is a stark reminder that a collapse in health threatens a collapse in the economic health of nations – and that leads to global instability.

Tech is our friend

While better guardrails, regulation and incentives to develop new drugs provide some comfort to those living with untreatable infections, there is a separate train of thought that has been developing in parallel with the problem of AMR, and that train of thought is now a mature market in its own right.

Anyone attending the Consumer Electronics Show – that Las Vegas bonanza that takes place in January every year – will have seen the consumer diagnostics industry vying with electric cars and experiential electronics for popularity.

We are in an age of knowing our numbers. Be it our body mass index, our blood pressure, our glucose levels or our pulse. As we learn about exercise, nutrition and our body’s reaction to them, we are finding out what we need to do to stay healthy before we reach crisis.

It is the same with diagnostics. Diabetics now know their numbers, we can easily purchase testing strips at pharmacies to find out whether we have an infection or temporary discomfort, and Covid taught us that we need to know – as an individual – if we are a danger to others (the herd).

Diagnostics are getting better, lead times are getting shorter and health workers are being given new tools to tell us whether antibiotics/antifungals are even necessary. This should change the game.

Take back control

So, while we wait for investors to point our the cost of the crisis we have created, and for policymakers to act and drugmakers to bring new products to market, we have significant power in our own hands to learn, monitor and take control.

That is not to say serious illness can be managed in this way, but day-to-day testing to find out what irks us and whether it really calls for the use of medical therapies has to be something we can all take responsibility for.

If we can recycle, eat less meat and buy less plastic, we can certainly test for infection and act according to the facts.