Antimicrobial resistance - a major health problem

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Antimicrobial resistance is a major one health problem. More so as modern medicine is dependent on efficient therapies being available e.g., when doing major surgery or treating cancer.  In veterinary medicine, antimicrobials are one of the main tools in the veterinary toolbox for ensuring animal health and welfare. With resistance emerging for ever more antimicrobials and the lack of new antimicrobials since the 1980s (Davis, 2013) this veterinary toolbox is becoming empty.

Moreover the drug companies lack  economic incentives for developing new antimicrobials. The costs of new developing new antimicrobials appears to be in the same price range as new stealth fighter planes or nuclear submarines. Current control measures -  prudent use of antimicrobials, severe restrictions on their veterinary and human use, such measures will have their largest impact if implemented globally. Today these appear not to be sufficient for controlling the emergence.

Governments in the EU also lack of funds for their daily operations and welfare transfers, and are hunting for new sources of revenue. Thus making public funding for research into  developing new antimicrobials an ambitious but not so realistic proposition. Often with messy policy problems that cannot be removed or ignored one solution is taxation. (Benjamin Franklin said that death and taxes are the two certainties in life).

Therefore one idea is taxing the use of antibiotics on the veterinary side and possibly even on the human side. The tax could and should limit the indiscriminate or large scale use of antimicrobials, create incentives to find alternatives to using antimicrobials, and the collected taxes could fund development of new antimicrobials. In this case a Pigouvian tax (Vågsholm & Höjgård, 2010) could be envisioned and the amount collected could be based on the kgs of antimicrobials used,  the time until development of resistance and the costs for developing new antimicrobials. It is not a solution, but one additional element to in a comprehensive solution to this problem. Perhaps an utopian question - could one think of these new antimicrobials as public goods, to be held as a gold reserve for future public health protection?

Davies S. (2013) The drugs don’t work. A global threat. London: Penguin pages 97.

Vågsholm I, Höjgård S. (2010) Antimicrobial sensitivity--A natural resource to be protected by a Pigouvian tax? Prev Vet Med. 96(1-2):9-18. doi:10.1016/j.prevetmed.2010.05.003

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