Abstract
Abstract
Background
Antimicrobial resistance (AMR) causes high levels of global mortality. There is a global need to develop new antimicrobials to replace those whose efficacy is being eroded, but limited incentive for companies to engage in R&D, and a limited pipeline of new drugs. There is a recognised need for policies in the form of ‘push’ and ‘pull’ incentives to support this R&D. This article discusses China, a country with a rapidly emerging pharmaceuticals and biotech (P&B) sector, and a history of using coordinated innovation and industrial policy for strategic and developmental ends. We investigate the extent to which ‘government guidance funds’ (GGFs), strategic industrial financing vehicles (a ‘push’ mechanism), support the development of antimicrobials as part of China’s ‘mission-driven’ approach to innovation and industrial policy. GGFs are potentially globally significant, having raised approximately US$ 872 billion to 2020.
Results
GGFs have a substantial role in P&B, but almost no role in developing new antimicrobials, despite this being a priority in the country’s AMR National Action Plan. There are multiple constraints on GGFs’ ability to function as part of a mission-driven approach to innovation at present, linked to their business model and the absence of standard markets for antimicrobials (or other effective ‘pull’ mechanisms), their unclear ‘social’ mandate, and limited technical capacity. However, GGFs are highly responsive to changing policy demands and can be used strategically by government in response to changing needs.
Conclusions
Despite the very limited role of GGFs in developing new antimicrobials, their responsiveness to policy means they are likely to play a larger role as P&B becomes an increasingly important component of China’s innovation and industrial strategy. However, for GGFs to effectively play that role, there is a need for reforms to their governance model, an increase in technical and managerial capacity, and supporting (‘pull’) incentives, particularly for pharmaceuticals such as antimicrobials for which there is strong social need, but a limited market. Given GGFs' scale and strategic importance, they deserve further research as China’s P&B sector becomes increasingly globally important, and as the Chinese government commits to a larger role in global health.
Publisher
Springer Science and Business Media LLC
Reference72 articles.
1. Collaborators AR. Global Burden of Bacterial Antimicrobial Resistance in 2019: a systematic analysis, the Lancet. Published Online January. 2022;20. https://doi.org/10.1016/S0140-6736(21)02724-0.
2. O’Neill J et al. May., Tackling Drug-resistant Infections Globally, Final Report and Recommendations, 2016, https://amr-review.org/.
3. Chaudhary AS. A review of global initiatives to fight Antibiotic Resistance and recent antibiotics’ Discovery. Acta Pharm Sinica B. 2016;6(6):552–6.
4. WHO. Antibacterial agents in Clinical Development: an analysis of the Antibacterial Clinical Development Pipeline. Geneva: World Health Organisation; 2019.
5. IDSA, Combating Antimicrobial Resistance. Policy recommendations to save lives. Clin Infect Dis. 2011;52(suppl5):S397–428.