Opinion: A new panel could be our best weapon against drug resistance

Imagine a world where a simple cut could be a death sentence; where routine surgeries become impossible, and common infections transform into untreatable nightmares. This isn’t science fiction — it’s the looming reality of antimicrobial resistance, or AMR, a silent global health emergency that threatens to unravel decades of medical progress. As drug-resistant infections claim nearly 4.7 million lives annually and are projected to kill 70% more people by 2050, the global health community is pinning its hopes on an unprecedented intervention: the Independent Panel on Evidence for Action against Antimicrobial Resistance, or IPEA. Modeled loosely on the Nobel Prize-winning Intergovernmental Panel on Climate Change, or IPCC, this new body represents a critical inflection point in humanity’s most urgent public health challenge. IPEA will help to consolidate scientific evidence to inform policymakers and raise awareness about the rise and spread of drug-resistant infections. Unlike climate change debates of the past, there’s a rare consensus about AMR. Scientists, policymakers, and health experts agree on the problem’s severity and the broad strokes of its solution. Yet, agreement hasn't translated into decisive action. The proposed IPEA could be the catalyst that transforms understanding into a coordinated, global response — but only if it avoids the pitfalls of previous well-intentioned multilateral efforts like IPCC. Despite broad agreement about the nature of AMR, there still remain important gaps in our knowledge. Neither governments nor the private sector are fully compelled to make the investments and to take the necessary steps to fully respond within an overarching strategy and approach. For IPEA to address these gaps and to compel action, it will therefore need to live up to its name, by being truly independent and entirely focused on collecting evidence for action against AMR. Here are five critical considerations that can ensure that IPEA becomes a transformative force to address one of the greatest threats of our time. 1. Avoid duplication In the area of evidence-gathering, it is key to avoid duplication. Many areas of AMR are already well-covered. Excellent work has been done, such as the World Health Organization’s priority pathogens list, and the work that has gone into antibiotic pipeline analysis and surveillance, with two global burden of disease reports now published. So, instead, the focus should be on identifying cost-effective, evidence-based solutions. This should reduce the need for regional institutions, governments, and organizations to conduct such research and analysis in ways that could also be duplicative and expend scarce resources. 2. Develop a clear set of targets We need IPEA to set targets that are both meaningful and helpful. While some high-level targets were established last year as part of the United Nations Political Declaration on AMR, there is still a need for more technical targets that cover all human, agricultural, and environmental aspects of AMR. This should also include indicators to allow for monitoring the progress of governments, the private sector, civil society, and others toward their AMR National Action Plan obligations. Targets to improve equitable global access to antibiotics must also be set. Currently, more people die from a lack of access to antibiotics than from drug-resistant infections. Improving access to antibiotics is the single most effective way of reducing mortality and morbidity from drug-resistant infections, because it not only protects individuals from infections but it prevents the infections from spreading to others. IPEA can help to achieve this by building a scientific and evidence-based approach to improving access to antibiotics and by supporting the development of rapid, low-cost diagnostic tools for identifying drug-resistant infections, without which we are currently flying blind. 3. Run a lean operation Size also matters. To ensure that most of its limited resources go toward the collection of evidence and data, and supporting the work of its experts, IPEA will need to be lean. There is simply no reason for it to be the same size as IPCC, which in contrast needs a relatively large secretariat to support its bureau of scientists as they coordinate the work of thousands of experts and scientists around the world. 4. Focus on the science Perhaps most importantly, we should resist the temptation to fill this panel with policy experts. For IPEA to be credible, and for its perceived independence and legitimacy to be preserved, it needs to be filled with people with scientific and technical expertise who have no conflicts of interest. That means explicitly excluding representatives of global health agencies, such as mine, as well as international organizations, companies, or institutions. Otherwise, it may be difficult for such representatives to separate out organizational interests from what the evidence and science dictates. 5. Emphasize a range of experience Finally, it is important that the panel be collectively made up of individuals who bring knowledge and expertise from a diverse range of technical, geographic, and economic backgrounds, while also representing, or speaking on behalf of, a broad range of people and groups that are at most risk from AMR. Ultimately, if the panel fails to take into account such groups, or fails to meet any of the above criteria for that matter, then the chances are it will fail. So, before any discussions about who should be appointed and before the jostling for position begins, there needs to be an agreed focus for the panel and its priority areas. If we get that right, then IPEA really does have huge potential to follow in the footsteps of IPCC and play a valuable role in the global AMR response.