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Using vaccine science to combat antimicrobial resistance

Alongside antibiotics, vaccines are an important and yet broadly underused tool in reducing the spread of antibiotic resistance globally. We are pioneering new vaccines to change that.

Since their discovery in the early 20th century, antibiotics have revolutionised human health care, saving and extending countless lives around the world. Before Alexander Fleming’s landmark discovery of penicillin in 1928, the average life expectancy was 47 years and the smallest cut had the potential to be fatal if it became infected.[2]

Over the last 90 years, the use of antimicrobials, and antibiotics in particular, have underpinned medical advances and expanded the scope of modern medicine.[2] However, the growing burden of antimicrobial resistance (AMR) poses a major global threat to individuals, public health, society, and economies worldwide. 

What is AMR?

AMR develops when microorganisms (bacteria, viruses, fungi or parasites) no longer respond to drugs designed to inhibit their replication. This resistance builds over time through mutation and overexposure to antimicrobial drugs especially when administered through sub-optimal treatment courses. Without effective treatments, these infections can remain, grow and continue to spread to other areas of the body.

The growing threat of AMR

Antimicrobial use and misuse of antibiotics is rising across the world, accelerating the rate at which resistance, including resistance to superbugs (bacteria with accumulated resistance to almost all available antibiotics), is developing.

This continued increase compromises our ability to treat common infectious diseases and could reverse the significant advances made in health care over the past century. Cancer therapies could become ineffective, routine surgeries impossible, or even childbirth less safe[3].

Meanwhile, developing new antibiotics is very difficult, both scientifically and financially. But our antibacterial research is focused on developing the next generation of antibiotics and we have an active pipeline of potential new medicines in development.

Over the coming decades, demographic shifts, climate change, and human migration, will compound AMR by making it easier for pathogens to spread. It is estimated that 700,000 people die every year due to resistant infections. In a worst-case scenario, AMR could claim up to 10 million lives each year by 2050, more than currently die from cancer and diabetes combined.[4]

Preventing infections to reduce the spread of AMR

At a time where most major pharmaceutical companies have moved away from antibiotic research, we have our own research unit focused on developing the next generation of antibiotics and an active pipeline of potential new medicines in development. Alongside antibiotics, vaccines are an important, and yet broadly underused tool in reducing the spread of antibiotic resistance globally.

Vaccinations can help to reduce an individual’s risk of infection, while training the immune system to recognise and develop a rapid and effective immune defence to a pathogen. Many vaccines can also help to protect unvaccinated individuals that cannot be vaccinated (for example people with a compromised immune system) through a process called ‘herd immunity’, which greatly reduces disease in the overall population. By reducing the spread of disease, vaccination subsequently lowers the need and use for antibiotic treatment, further limiting the opportunities for resistance.

At GSK, we believe that vaccinations could play a vital role in addressing the global threat of AMR. Our current portfolio of vaccines helps to protect tens of millions of people globally against a range of bacterial and non-bacterial infections.

By focusing on new scientific insights and novel technologies – such as adjuvants, Self-amplifying mRNA (SAM), bioconjugation and generalised module for membrane antigens (GMMA) – we would be able to target pathogens that are likely to develop resistance and develop effective vaccines more rapidly compared with traditional approaches.

We currently have several vaccine and medicine projects targeting priority AMR pathogens for the WHO, the European Centre for Disease Prevention and Control (ECDC) and the US Centers of Disease Control and Prevention (CDC).

For example, we are currently exploring the potential of new and existing vaccines to protect against RSV (Respiratory Syncytial Virus), as well as bacterial infections where increasing resistance to antibiotics is a concern, such as shigellosis, infections by Staphylococcus aureus, and Clostridium difficile and gonorrhoea.

How can vaccine science help fight antimicrobial resistance?

At GSK We believe our vaccine science can help address the global public health challenge of Antimicrobial Resistance

 

We are committed to exploring innovative approaches that can help tackle this rapidly emerging public health crisis, and are proud to have been ranked first in the Access to Medicines Foundation’s 2020 AMR Benchmark report, with almost a fifth of all R&D projects in the area.[1]

And while antibiotics continue to play a vital role, our improved understanding and expanding capabilities in vaccine development are opening up potentially new, effective ways to tackle the problem at the source, protecting more people from infectious diseases and reducing resistance. 

While there is a long way left to go in the fight against AMR, we are hopeful that these vital interventions – if successful - can have a significant impact on human health, enabling society to continue to explore the future of healthcare.

References 

[1] Adedeji, W.A.  The treasure called antibiotics. Ann Ib Postgrad Med. 2016 Dec; 14(2): 56–57.  Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5354621/#!po=8.33333 Last accessed 12 June 2020

[2] Shallcross, L.J & Davies, S.C, Antibiotic overuse: a key driver of antimicrobial resistance, Br J Gen Pract. 2014 Dec; 64(629): 604–605.  Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4240113/#__ffn_sectitle Last accessed 12 June 2020

[3] World Health Organization, ‘About AMR’. Available at: https://www.euro.who.int/en/health-topics/disease-prevention/antimicrobial-resistance/about-amr Last accessed 17 June 2020

[4] HM Government, ‘Antimicrobial Resistance: Tackling a crisis for the health and wealth of nations’, p.5. Last accessed https://amr-review.org/sites/default/files/AMR%20Review%20Paper%20-%20Tackling%20a%20crisis%20for%20the%20health%20and%20wealth%20of%20nations_1.pdf Last accessed 12 June 2020

[5] Access to Medicines Foundation, Antimicrobial resistance 2020 benchmark.  Available at: https://accesstomedicinefoundation.org/amr-benchmark/2020-benchmark. Last accessed June 2020