Huffington Post; November 12, 2015. Brazil, India, Russia and China have gone through a period of rapid economic development, making them important global players in the 21st century. However, they are also the countries that might be affected most severely by growing antimicrobial resistance, which could lead to 1 million deaths in China alone by 2050.
When Goldman Sachs published, “Building Better Global Economic BRICs” in 2001, it was a somewhat controversial paper, that predicted Brazil, India, Russia and China had the potential to grow hugely over the next 10 years*. It paved the way for subsequent research estimating that these will be four of the world’s largest economies by 2050. After 14 years of rapid growth, the BRIC countries have doubled their share of the global economy. So the first prediction has been fulfilled and the second looks to be on track too. The reason we, like many others believed these countries could grow so quickly was that none seemed to be living up to their potential. With larger populations, better levels of education and all four starting to develop their own technologies and adapt global ones while improving their infrastructure, their potential was more likely to be achieved.
Some of that potential is bearing fruit already in certain areas, despite the many economic challenges encountered on the way since 2001. But these countries have much more to offer. As they become the global political and economic powers of the future, we encourage them to seize this. From the upmarket handbags to the latest iPhone, so many of the world’s goods are now designed in the West, made in the BRICs. The next step for BRIC countries should be to use their new found wealth, and their creativity, to lead on research and development too.
Two areas where there is a lot of scope for BRIC countries to lead on are drug and diagnostic development, and in particular an area that’s close to our hearts, the fight against drug-resistant infections or so-called “superbugs”. We believe that the BRIC countries efforts and leadership are crucial if we are to solve this global problem. The Independent Review on Antimicrobial Resistance** has estimated that in scenarios where AMR is allowed to increase significantly, more than 10 million people a year would die of resistance by 2050, and $100 trillion would be wiped off cumulative global production over the next 35 years. Tragically, more than a third of the deaths and productivity losses in these forecasts would be in the four BRIC countries. Those affected the most should lead the way in stopping this terrible problem, rather than hoping someone else takes the lead.
The BRICs are the centre of the world’s generic drug production. They have managed to lower the cost of drug production and make medicines affordable to more people than ever before in history. They’ve also made great strides to lower the costs of complex therapies, such as organ transplants. Going forward they can find further solutions that the world needs. Earlier this month China’s scientist Tu Youyou won the Nobel prize, for the discovery of artemisinin, adapting it from traditional Chinese medicine. This is the main drug we use today to fight against Malaria. Russia leads the world on phage therapy, an alternative to antibiotics. Bangalore is a hub of diagnostic research, and India has the potential to be truly world-class in this area. And, Brazil’s fast growing pharmaceutical industry is already a world leader in the battle against TB.
Going forward the BRICs should build on their own success, by finding useful and innovative solutions that meet the needs of not just their people, but the whole world. It is India, Brazil, and possibly China, who will suffer if malaria resistance is not kept under control, not Europe or North America. Viral, fungal and bacterial infections are also far bigger problems for these large emerging economies than in high income settings. This is the main reason why they should take their place on the world stage and lead the fight to find solutions to these global problems. It is also something their own pharmaceutical industry will greatly benefit from.
We urge the BRIC nations and other large emerging world economies to use their power in the G20 to push for global change in how we fund and tackle the rise of drug-resistant infections. In particular China, who is hosting the G20 next year. We also encourage them to participate in the nascent global innovation fund for AMR so that their researchers and companies can access the funding that will be made available and help solve health problems that are affecting their citizens first and foremost. Finally, we need the BRIC countries to weigh in on the discussions by the G7 and the OECD about how to best fund the commercial rewards for organisations that come up with useful products, while ensuring these drugs and new technologies are available to people everywhere, in rich and developing economies alike. The Review on AMR set out proposals to incentivise the drug and diagnostic development that we need most to win the fight against drug-resistant infections. Development is necessary in the area of new antibiotics as well as combination of newer and older antibiotics, antibiotics with enhancers, incremental innovation of older antibiotics including newer delivery systems. To support all this research – from truly novel products to improvements on existing technology – we need clear new thinking in the areas of regulatory approvals, efficient clinical trial platforms and access to markets to make sure that innovation and new products benefit the patients who need them.
The BRICs should set their local industries the challenge of coming up with the drugs and diagnostics that their citizens need. While the original vision for the BRIC countries in 2001 is on its way to becoming a reality, there is still so much potential to tap. The issue of AMR is one area amongst many, where these nations can lead the world. We hope they take this opportunity.
Dr. Martha Penna, MD, is Vice-President of Strategy and Innovation at Eurofarma, a leading Brazilian pharmaceutical company
Dr Yusuf Hamied, is Chairman of Cipla, a leading Indian pharmaceutical company
Jim O’Neill, a former Chairman of Goldman Sachs Asset Management, is Commercial Secretary to the UK Treasury and Chairman of the Review on Antimicrobial Resistance