Science and Policy Exchange’s first public forum
On March 10th 2015, the Science and Policy Exchange hosted its first public forum, “The Truth about Antibiotics: Superbugs and What You Need to Know,” consisting of a panel of expert speakers who discussed the topic of antibiotic resistance from various contexts.
The evening began with a witty introduction from Dr. Albert Berghuis (McGill University). Dr. Berghuis warmed up the crowd of almost 100 with a timeline of antibiotics and antibiotic resistance. “Penicillin started it all.” Since then, other antibiotics have been discovered, however, this has plateaued significantly with very few new antibiotic discoveries occurring in the past few years. A scarier fact is that currently, there are no antibiotics without resistance. Dr. Berghuis then introduced “the perfect storm:” a combination of the decline in antibiotic discovery and the increase in antibiotic resistance. Dr. Berghuis ended by stating that we need better drugs. Science and research can provide clues to answering the problem of antibiotic resistance, however this is not a “one way problem,” and cannot be answered by science and research alone, highlighting the importance of the forum’s dialogue between the different panelists.
The first panelist of the evening, Dr. Karl Weiss (Université de Montréal) began by emphasizing that few advancements in the field of medicine have impacted life expectancy as antibiotics have. He then stressed that a major threat leading to the increase of antibiotic resistance is worldwide travel. Antibiotics are easily accessible in most of the world, however, there are many differences in regulations between different countries. For example, only 50 of 200 countries require a prescription to obtain antibiotics. This becomes problematic because resistance is no longer restricted to one location – when people travel, antibiotic resistance travels with them. Although use of antibiotics is more controlled in Canada, Dr. Weiss believes that there is still room for improvement by changing the prescribing behavior among family physicians. With that being said, Dr. Weiss reiterated that “antibiotic resistance is [still] one of the most threatening issues in medicine today.”
Dr. Vinay Thatte (Health Canada) then introduced the audience to the Canadian drug approval process. All drugs, including antibiotics, have side effects and Health Canada works to measure the risks vs. benefits of each new drug. After the long process of drug discovery, each new drug must then go through a rigorous approval period before being released onto the market. This is a lengthy process as a lot of information needs to be reviewed to ensure that the standards are met for three major areas: safety (warnings, precautions, adverse reactions), efficacy (benefits, dosage, population), quality (stability, impurities, sterility). Once approved, all of this information is openly accessible as a product monograph which Dr. Thatte strongly encourages consumers to seek out. Additionally, after drug approval, Health Canada continues to monitor safety while the drug remains on the market. Dr. Thatte concluded by reassuring that: Canadians should feel safe about the drugs that they are consuming!
Dr. Marie Archambault provided yet another facet of antibiotic resistance from the perspective of veterinary medicine. A similar trend of the evening emerged as Dr. Archambault began her dialog stating that antibiotic resistance is the largest, continual threat again humans and animals. In veterinary medicine, the use of antibiotics is used for treatment, growth promotion, and for prophylaxis. Proactive countries such as Sweden have banned the use of antibiotics as growth promoters and Dr. Archambault is hopeful that antibiotics will soon be banned in Canada for this purpose. She then proudly discussed how Quebec is a “pioneer” of the country with very active regulation of antibiotic use. Some examples of such pioneering in the field includes: mandatory prescriptions for antibiotic usage among animals, mandatory certification in bacterial resistance, and surveillance of antibiotic use and bacterial movement in animals. Dr. Archambault ended her panel with the importance of the veterinary community and other experts in the field to become the leading forefront of antibiotic resistance stewardship.
The last panelist of the evening was Mr. Michael Atkin (Sopharmia Inc.) who spoke of antibiotics in the context of the pharmaceutical industry. Mr. Atkin started off with the poignant fact that antibiotics are a $38 billion market that still “can’t get no (any) respect.” The antibiotics market is an invisible market of high volume, low priced, generic drugs. In terms of the numbers, each new drug costs $2 – $5000 over a short course treatment, therefore fewer pharmaceutical companies are invested in a market that does not have a huge payout. Mr. Atkin believes that truly novel, creative antibiotics can overcome the hurdles of field and revive the market. Finishing with some positive remarks, Mr. Atkin pointed out that although many large pharmaceutical companies have left the antibiotics field, more venture capitalists and some governments are recognizing the threat of antibiotic resistance and are beginning to invest more money for antibiotics for resistant microbials. In a case of “the revolving pharma door,” many pharmaceutical companies are slowly becoming interested in this field again.
The floor was then opened to the public who had many burning questions leading to a thought provoking discussion. The discourse ranged from topics about the changing (and improving) societal views of antibiotics to the importance of basic and academic research, with the overall awareness that more needs to be done in this field or else human health will take a huge hit. A lengthy discussion regarding whether we are “losing a battle to [antimicrobial] evolution” had all the panelists weighing in. The general consensus of the evening was an optimistic one; with novel, creative, and multiple approaches, the panelists believe that the situation of antibiotic resistance will get better as evidenced in other countries.
*Summary piece was written by Vicki Leung, a dedicated SPE volunteer with inputs from Noura Redding, then Vice President of Communications, SPE.
Dr. Albert Berghuis (McGill University) will explain the history of antibiotics, describe how they have been able to evolve and adapt, and current research avenues
Dr. Marie Archambault (Universite de Montreal) will discuss the need for antibiotic use and address concerns about misuse in the food industry
Dr. Karl Weiss (Universite de Montreal) will present the development of antibiotic resistance in hosipitals, its implications on human health and how to address its misuse by healthcare professionals
Mr. Micheal Atkin (Syzent Partners Ltd.) will address conflicting interests of the pharmaceutical industry and look at how governments can create funding programs to improve research and development for new drug discoveries
Dr. Vinay Thatte is currently the Manager for AIDS and Viral Diseases Division and Division of Anti-Infective Drugs in the Bureau of Gastroenterology, Infection and Viral Diseases of Therapeutics Products Directorate, Health Canada.