If left unchecked, antibiotic-resistant microbes could kill 10 million people by 2050, according to the World Health Organization. Frédérique Vidal announced Wednesday, 40 million euros to fund a plan to fight against antimicrobial resistance. It will be piloted by Inserm.

The urgency of the fight against antimicrobial resistance is comparable to that against climate change. This was said by several speakers at the interdepartmental symposium dedicated to the needs of research, which was held Wednesday, November 14 at the Ministry of Health.

The problem is just as global, concerning both human health, animal health and the environment, at the global level. Indeed, the most common antibiotic resistant bacteria, and the appearance of superbugs resistant to all treatments are common to animals and humans. And they play borders.

Resistance genes circulating in the environment (via wastewater for example) contribute to their dissemination. Antibiotic residues can also promote the selection of resistant strains.

33,000 annual deaths

A study recently published in the medical journal The Lancet assigns 33,000 annual deaths to antimicrobial resistance in Europe, with children under 1 year and over 65 years old being particularly affected.

The World Health Organization has sounded the alarm for several years. The specter of major health disasters is not a fad. She recently published a list of particularly dangerous bacteria, four of which are considered critical.

Stay in the race against a major risk

In 2016, France has a roadmap for the fight against a scourge that is still of little concern to the general public. On Wednesday, at the end of an inter-ministerial conference, the Minister of Higher Education and Research Frédérique Vidal, announced an endowment of 40 million euros for a plan coordinated by Inserm (medical research).

This money can subsidize research in both human and animal health, or foster innovation in partnership with the private sector. The goal is that French research remains in the race against a risk of global scourge.

40 million, this may seem like little while the development of a truly new antibiotic can amount to hundreds of millions of euros. The problem is precisely that there have been very few discoveries of new antibiotics in thirty years. And the big pharmaceutical labs have turned away from a sector considered unprofitable.

Therapeutic tracks

Young biotech companies have entered the niche. But new antibiotics are not the only therapeutic resources. Among the many strategies, research on bacteriophages (viruses killing bacteria), for example, is revived or, more surprisingly, the use of monoclonal antibodies, which is usually associated with the fight against cancer.

These targeted therapies, which can target an element of the bacteria to make it harmless, are very promising, according to Bruno François (CHU Limoges) because they provide prolonged protection. Many of these antibodies are in the process of being certified.

Abuse and misuse

Of course, abuse and misuse of antibiotics accelerate the resistance of microbes. In Europe, the use of antibiotics to promote the growth of animals has been banned since 2006. And the use of certain classes of antibiotics, called critical, those used when a first resistance appears, has been severely regulated. This is not the case everywhere.

In France, however, the efforts are crowned with effect, the exposure of farm animals to antibiotics would have decreased by 37% in five years, 80% for critical antibiotics.

In human health, however, the use of antibiotics is exploding in Asia, particularly in India and China. France remains a bad student. With a consumption 30% higher than the European average, while "30% to 50% of prescriptions are useless" , according to Jerome Salomon, Director General of Health. France would be the sixth country most affected by antimicrobial resistance.

Four axes

The plan of struggle will follow four axes: the study and the fight against the emergence and the dissemination, the curative and preventive strategies, the development of new technologies of health (Artificial Intelligence, diagnostic tests) and the "social" studies.

This plan complements initiatives already launched. The inserm had already received 2.5 million euros to structure the fight. The National Research Agency had already prioritized 6 million euros in funding for programs dealing with antimicrobial resistance. Last year, BPI France contributed some 15 million euros to the young French biotech Deinove, for the development of new antibiotics.

In 2017, after a meeting between Emmanuel Macron and Angela Merkel, Franco-German research programs were initiated. In the area of ​​antimicrobial resistance, each country contributed 7 million euros.

France is very active in the JPI AMR program, a barbaric name for a program born in Europe ten years ago, but which now involves 26 countries, financing research projects. Between 2014 and 2017, it contributed 52 million to 50 projects involving several territories each time. The originality of the device is that the money provided by each state will be directed to the labs of his own country, but that the European Union provides additional funding.