More diverse research funding for animal antimicrobial resistance key to tackling global health issue
Antimicrobial resistance (AMR) is a serious public health issue that kills an estimated 700,000 people a year and is eroding the effectiveness of the life-saving antibiotics we rely upon. Not only does AMR present risks to human health, it also has severe implications for the health and welfare of animal populations, with major food security and environmental implications. Globally, the antimicrobials procured for use in the animal sector are nearly double those purchased for the human health sector. This is a worrying fact, since the use of antimicrobials in animals can lead to antimicrobial resistance in humans through direct and indirect transmission mechanisms, such as exposure to livestock infected with AMR pathogens or through contaminated retail meat.
AMR is an international development issue
In 2016, the United Nations recognized that AMR disproportionately affects low- and middle-income countries (LMICs), where its spread is encouraged by a combination of factors related to poor hygiene and sanitation, limited access to adequate healthcare infrastructure, and a lack of regulation. The highest burden of communicable diseases are also borne by LMICs, where there is generally limited data on the epidemiology of AMR and fewer resources to address the issue.
Global maps of AMR show hotspots of resistance in northeastern India, northeastern China, northern Pakistan, Iran, eastern Turkey, the south coast of Brazil, Egypt, the Red River delta in Vietnam and the areas surrounding Mexico City and Johannesburg, South Africa. Areas where resistance is just starting to emerge are Kenya, Morocco, Uruguay, southern Brazil, central India and southern China. Given the severity and extent of the problem, failing to prevent the continued emergence of AMR will likely jeopardize progress towards achieving the United Nations Sustainable Development Goals.
Addressing the emergence and spread of AMR in the animal sector of LMICs requires context-specific research conducted in those countries, by and with locally based research institutions. To provide insight into this issue, IDRC has collaborated with the Global AMR R&D Hub using AMR investment data from the Hub’s Dynamic Dashboard to produce a report analyzing the funding patterns of R&D in animal health AMR in low- and middle-income countries. The Hub was launched in 2018, following a call by G20 leaders, to improve coordination and collaboration on global AMR R&D. In publishing this report, our two organizations hope to provide insight into investment and data gaps to inform the international community and provide evidence to help set future funding priorities in AMR research. Below are a few major findings from this exercise.
Relatively little funding goes directly to research institutions in LMICs
Although the use of antimicrobials in the animal sector vastly exceeds their use in human health, only 11% of all recorded R&D funding to address AMR involves animal health. While this funding totals USD8.91 billion (approximately CAD11.26 billion) since 2017, less than one third of this amount – USD301 million (approximately CAD380 million) – has involved low- and middle-income countries.
The report found that in the vast majority of animal AMR research projects involving LMICs, both the funder and the lead research organization are based in a high-income country. This is called Type 3 investments. There are relatively few animal-sector AMR research projects in which both the funder and the research organization are based in the same low- or middle-income country (Type 1 investments), or where the funding institution is based in a high-income country with the lead research organization based in a LMIC (Type 2 investments). Only 4% of R&D funding to address animal-related AMR is directed at research institutions in LMICs.
The lack of direct funding to LMIC-based research organizations is a significant gap, since these direct investments enable researchers from LMICs to contribute to global research agendas and generate locally-relevant knowledge for those regions.
IDRC is among the few funders of Type 2 investments through the Innovative Veterinary Solutions for antimicrobial resistance (InnoVet-AMR), a CAD30-million partnership with the UK Department of Health and Social Care’s Global AMR Innovation Fund. Through this partnership, we fund the work of 11 research organizations to develop new alternatives to antibiotics for food animal production.
Funding in animal health AMR R&D is highly concentrated
The bulk of all funding in animal health AMR R&D comes from funders based in the United Kingdom. Investment data shows that the UK’s public sector is a global leader in this space. But AMR is a global issue whose risks are borne by all countries. To continue advancing knowledge and developing solutions for AMR for the animal health sector, it is important for funding to come from multiple sources.
AMR R&D in aquaculture remains underfunded
Aquaculture systems produce a far greater variety of species than land-based animal production. This subsector has grown extremely rapidly over the last 60 years. The diversity of production systems in aquaculture, combined with the major environmental risks associated with water contamination, make aquaculture fertile ground for AMR research. This is a priority gap addressed by InnoVet-AMR: four of the 11 projects supported by this program are focusing on alternatives to antibiotics for aquaculture.
The trends in AMR funding in animal health highlighted in the report can provide a starting point to address potential funding gaps globally and inform research funding agendas. To tackle this global issue, global solutions are required, with the involvement of LMIC funders, research organizations and policymakers at all levels and as equal partners.
Read the full report here.