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WASHINGTON -- Large pharmaceutical companies, investors, and other funders must increase investments to address antimicrobial resistance (AMR), and must do so now, experts and industry insiders said here this week.

However, most expressed skepticism that this will happen.

Speaking at the annual , Greg Frank, PhD, director of global public policy for Merck, noted that "there's very big challenges" in raising funds to address AMR.

Mary Schaheen, president of , an investment fund focused on life sciences companies, said her firm wants to help, but there seems to be a disconnect. It has become harder to find smaller companies developing new therapies that her firm wants to fund, but she hears the smaller companies struggle to find funders.

AMR has been called the silent pandemic by many public health experts, with new antibiotic-resistant bacteria emerging and more strains likely coming given antibiotic overuse internationally, not to mention the scarcity in new drug development throughout the 21st century to counter them.

"There is significant disincentive now to invest in [AMR drugs]," said John Billington, MPH, head of health security and infectious disease policy and advocacy for GlaxoSmithKline (GSK). That's largely because companies do not anticipate much return on their input, he noted.

"There's a market failure," said Sarah Despres, JD, an HHS public health counselor. One conundrum, for example, is "no one's going to make a product to sit on the shelf, but we need products to sit on the shelf."

Billington suggested entities share risk to spur investment. Other speakers cited potential solutions such as the in the U.S., a pilot incentive program in the European Union, and the work of the international .

The Action Fund saw increased activity during the COVID-19 pandemic, perhaps driven by more public attention to the possibility of pandemics occurring, said Aleks Engel, PhD, a director at investment company .

In addition, the G7 finance ministers have "finally committed to tackling this," said Dame Sally Davies, MB ChB, MSc, a U.K. special envoy on AMR. They have realized AMR is not just a public health issue, but also an economic problem. The G7 has the power to tweak the market and make it more attractive for larger AMR investments, in part by "mapping" antibiotic supply chains, she noted.

Davies also called for investors to incorporate AMR into their standards, citing an appeal from the advocacy coalition .

Aetna wants to collaborate with urgent care providers, as well as state and national medical societies, to address the issue, said Rick Watkins, MD, a medical director for the company.

Some speakers also cited vaccines as a potential answer to AMR and encouraged funders to invest in them. Leonard Friedland, MD, vice president of vaccines for GSK, called vaccination "an essential tool to stem the tide of antimicrobial resistance," albeit not a comprehensive one. "There are many reasons to think we could do the same for antimicrobial resistance as vaccines are doing for COVID," he added.

"Novo and 'Big Pharma' are both more interested in developing vaccines in the wake of the COVID vaccines' successes," noted Engel.

But Friedland pointed out that existing AMR vaccine models would treat a very small population of patients because they would be targeted only to specific microbes -- not all AMR bugs and potential threats.

Developers still need to answer who and what precisely the vaccines would be for, said William Hausdorff, PhD, of the global nonprofit , noting that vaccines will cost companies a lot of time and money to cultivate.

Many sources privately expressed skepticism to 乌鸦传媒, saying that funders are unlikely to invest anywhere near the resources needed to properly address AMR overall -- which some pegged at a few billion dollars. These included leaders of the smaller biotech companies that are actively swinging away at the problem with novel ideas that they said need more venture capital to nurture.

Too many of these biotechs run out of funding while trying to develop new drugs, said Martin Heidecker, PhD, the Action Fund's chief investment officer. Better-resourced companies need more incentives to help these biotechs and otherwise invest in addressing AMR.

Despite the growing threat and acknowledgment of the problem from larger companies, during a panel dedicated to AMR investment, Michael Chang, MPH, of investment firm , said, "I don't hear a lot of concern from investors" about AMR and how it is affecting their current investments outside this space.

To this, Frank expressed remorse and noted that addressing AMR helps the rest of their public health investments function, given how AMR is entrenched within public health. "If nothing changes, we'll continue to struggle," he said.

However, Schaheen expressed some optimism. She called investing in addressing AMR "a sleeper space."

"We face a crossroads for antimicrobial resistance," Davies said during a presentation. Noting that the COVID pandemic could accelerate the AMR pandemic, she added, "We need to make bold moves and we need to make them now ... Patients deserve better."

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