Description: Proposes a Global Innovation Fund of \$2bn over 5 years for early-stage and non-commercial research; and a system of market entry rewards of around one billion USD per drug for effective treatments.
Start date: Commissioned in 2014, reported in 2016.
The AMR Review was commissioned in 2014 by David Cameron, chaired by Jim O’Neill, and funded by the Wellcome Trust and the UK government.1
At the end of the two year reporting process, the AMR Review proposed the creation of a Global Innovation Fund of \$2bn over 5 years for early-stage and non-commercial research; and a system of market entry rewards of around one billion USD per drug for effective treatments.2 These rewards would be allocated conditional on affordable access and in proportion to social value.3
The report set out a number of possible sources of funding. A percentage of government or international organisation spending could be allocated to AMR.4 Alternatively, mechanisms like a charge on pharmaceutical companies, a tax on antibiotics or a new antibiotics voucher could be used.[^18]
Scope: The proposed fund would target all stages of R&D in the field of antibiotics.
Access: The price of antibiotics would fall, as prizes would be conditional on affordable access. With regards antibiotics, the primary problem is over-prescription rather than under-availability, so distribution incentives are not salient.
Innovation: The prizes would be allocated in relation to social value, so incentives would be linked to some proxy for health impact.
Efficiency: The prize element of the fund is market based.
Governability: The fund would require complex global governance, and for states to cede control over this part of spending. The selection process would need to be robust against political interference.
Political Feasibility: There is wider interest in AMR globally, including discussions at the G20.
The idea behind this fund is similar to that of the WHO Global Consortium, proposed in 2014, and GUARD, proposed in 2017.
The AMR Review proposal is a mixed proposal incorporating both grant funding (push mechanism), prizes (pull mechanism), and a commitment to open intellectual property rights. Structurally this makes it very similar to the 3P Project, which incorporates push, pull and pool factors. The 3P Project focuses on a narrower area, aiming to create a one-month affordable regimen for tuberculosis. It also explicitly proposes using the Medical Patent Pool (MPP) to gather patents, whereas the AMR Review proposal merely makes a general statement in favour of delinkage.
The fund part of the AMR Review proposal is similar to the WHO biomedical convention proposals, the Health Product Research and Development Fund, the Medical Innovation Prize Fund (MIPF), the Medical Innovation Prize Fund (MIPF), the Cancer Innovation Fund (CIF) and und for research in Neglected Tropical Diseases (FRiND). However, unlike most of those proposals, the AMR Review envisages a fund that is primarily for early stage or non-commercial research. It would therefore be impracticable to make funding conditional on impact (which is far in the future and difficult to attribute for such research).
The prize part of the AMR Review proposals resembles the Chagas Disease Prize Fund and the Tuberculosis Prize Fund, except that the AMR prize would operate exclusively through milestone prizes, rather than a combination of different prize types.
Stakeholders on board: The UK government in 2016
Official website: “Home | AMR Review.” Accessed July 19, 2017. https://amr-review.org/.
Final report: Jim O’Neill. “Tackling Drug-Resistant Infections Globally: Final Report and Recommendations.” The Review on Antimicrobial Resistance, 2016.
UK Government response to report: “Government Response to the Review on Antimicrobial Resistance.” HM Government, 2016. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/553471/Gov_response_AMR_Review.pdf.
Preliminary report: Jim O’Neill. “Securing New Drugs for Future Generations: The Pipeline of Antibiotics.” The Review on Antimicrobial Resistance, 2015.