 Good afternoon and welcome to this press conference from the 48th annual meeting of the World Economic Forum here in Davos thank you for those of you in the room who made it through the snow to be with us and Much easier for those of you who are on our live stream But still thank you for watching this press conference is dedicated to the launch of the first-ever anti microbial resistance benchmark and We will hear what that means and what the results are in a minute But first of all, let me introduce the wonderful panel. We have here today to speak about that topic on my immediate left We're joined by Jay here. She's the executive director of access of the access to medicine foundation We have Paul stoffels who's the executive vice president, but more importantly the chief scientific officer of Johnson and Johnson Teams to his immediate left. We're joined by a professor Jeremy Farah Who's the director of the welcome trust and all the way down on the other side of the panel We're pleased to be joined by Julian Braithwaith Who is the ambassador and permanent representative to the UK mission to the end and other? International organizations in Geneva so to speak a neighbor of the world economic forum Welcome to all of you and and thank you for being here Jay Let's let's kick things off right with you The first ever end-time microbial resistance benchmark tell our audience here, but tell also our live stream audience What does that mean and what are the key findings of that benchmark place? Sure great? So thank you again for everyone who's joining us today I know there's a lot of exciting things going on around Davos So I really appreciate that you spend the time talking about this very important topic. I'm Jay I run the access to medicine foundation I'm going to take you through a couple of key results coming from the AMR first ever AMR benchmark So it's the first independent analysis of what the most active players in the pharmaceutical sector are doing to slow the emergence of drug Resistance my research team and I have been looking at the big pharmaceutical companies biotechnology companies manufacturers of generic medicines and they are the biggest players when it comes to the volume of antibiotics being produced Now we all know that the problem of superbugs or antimicrobial resistance is high on the international agenda It has been discussed right here in Davos two years ago And it has also been in the G20 the World Health Assembly and the UN General Assembly There's a growing recognition that we need to do something about this particular threat So the benchmark is basically a series of evaluations at the foundation what we do is We are supported by the as a foundation we're supported by the Bill and Melinda Gates Foundation the UK and the Dutch government And this particular benchmark is supported by the UK's department for international development and the Dutch Ministry of Health Welfare and sports So the main reason that we are working on a benchmark is we're trying to first clarify the role of the pharmaceutical industry on what is expected from them in terms of tackling this this important threat The second thing that we do is we transform that expectation that we derive from various different experts into metrics and we use that metrics to analyze company behavior company actions and activity into Translating it into how they act on this particular threat so what we reasonably expect from the industry is That apart from developing new medicine and vaccines We also expect them to manufacture antibiotics Responsibly so that their factory wastewater doesn't release antibiotics into the environment And we also expect these products to be marketed and promoted very carefully So to make them available without encouraging doctors and patients to overuse or misuse them so how are they doing who are the leaders the news release that many of you have access to outlines the benchmarks for key findings and how the companies are performing but in general We found more evidence of action against drug resistance than certainly others many experts have expected GSK and Johnson and Johnson provided the most evidence of the most activity in the broadest range of areas that we measured Compared to the other big pharmaceutical companies and that's why they leave the group of Companies and we're about to hear from Paul in a few minutes Among the generic companies my land sipler and Fresenius Kabi are doing the most again in terms of various different actions to control antibiotic use and Entosys a US based biotechnology company leads the biotechnology industry when we look at the three four areas that we Have been focusing our attention on research and development We found that new medicines and vaccines are in the pipeline and more than half of the pipeline Of anti-infectives target some of the most toughest pathogens to treat that include gonorrhea Tuberculosis E. Coli Salmonella the plague all diseases that are becoming untreatable so companies are putting their R&D efforts in the right direction There are 28 antibiotics and clinical testing that target tough pathogens only nine of them are truly novel And this may sound like a lot, but it's not enough to replace the medicines that are that are losing their effectiveness Drug development has a high failure rate as many of you are aware of and to be safe We need far more in the pipeline and we appreciate organizations like the welcome trust And the UK government in supporting more action in drug development and AMR from various different parties What's surprising to us is that companies are taking actions that at first glance seem to be running counter-intuitive To their interests for example, there's a core group of companies Changing the way that they encourage sales Their sales staff to perform so instead of setting reward of sales staff to sell more antibiotics These companies reward staff on their technical knowledge at service level and by decoupling bonuses from sales volume companies are reducing the chance That antibiotics will be oversold We also see companies are managing to balance the need between making antibiotics accessible while ensuring that they can be used sparingly This is particularly important in poorer countries without health systems that can control Access to antibiotics for example, there's a new breakthrough medicine for multi-drug resistant tuberculosis from Johnson and Johnson That I think Paul will speak about that has been brought to patients in a way that enables yet tightly manages access to medicine and What should happen next it depends on the company in question Their business models are very different and this is a very challenging market commercially scientifically and also in terms of regulatory Barriers, I would say that all companies must look very carefully at what antimicrobials they are the market how they're selling them and the industry Of course along with governments need a new mindset to see how they can manage Products to make sure they continue working for as long as possible I want to make one last point given all the talk about controlling antibiotics about the importance of access People living in poorer countries are usually at the front line of AMR. They generally lack reliable access to antibiotics when they need them and they also have poor health care advice and In that way they face higher levels of resistance and also higher higher morbidity and mortality due to infectious diseases Many of the factors that play in in certain countries prompt people to use antibiotics that usually end up encouraging resistance rather than discouraging resistance itself So to put it very simply the most important thing that we need now is for multistakeholders to act I think Davos is an important platform where political leaders global health leaders industry leaders intellectual leaders Come together and talk about important issues like this like AMR and what we need is while the economics are complex We need to know we need more industry members new more pharmaceutical companies to develop new Antibiotics and new medicines new vaccines replace the ones that no longer work and find new Responsible ways to produce them and get them to the patient We'll be tracking the industry again The next benchmark will be published in two years and we'll be refining the metrics Raising the bar and looking to see what people will be doing in the next couple of years on this issue. Thank you Thank you, Jay Paul. Let's let's come to you Jay mentioned that you participated Broadly in this benchmark. What do you think it's important and what drove you to to that participation? Well, Jay, thank you for your summary Why it is important is that on the one hand? It is looking at industry on what they do well and what can do we do better at the same time It puts a highlight on the challenge of developing this type of medicines it's a very long story to from discovery to development to implementing and and With with a lot of challenges throughout the pipeline to get there And so I'm very pleased that AMR benchmark shows that it can be do it can it is doable to do it And it's work across civil society governments donors and industry to in the end make new medicines for For AMR and AMR is a disaster waiting to happen. We have seen we have seen it evolving over the last few years We particularly in TB and an XDR a multidrug resistant to be as we are working in this space It's just amazing on on the on the increase and how how we will have to handle in order to to make sure We get it under control we as an industry and particularly as a company Johnson and Johnson We have a long-standing commitment to making and the Antivirals antibiotics we are working on vaccines and now on a TB drug. We are there for 50 years and doing more but at the same time it When you develop a drug like Jay was saying where you have a very limited ultimate Population is going to use it who are you protected for that population the challenges on how can you get it developed and and and implemented correctly and I'm very proud that that what we have done with Zirturo a new drug for XDR and MDR TB is that is that it can you be used as an example on on how you can do it first of all It was developed only in XDR TB to start with now. It's expanding to MDR TB We we start the first publication on it was 2004 when we discovered the medicine from then to now It's now 13 years later First it took us almost nine years to develop and now we are implementing it country by country 80% of XDR TB is in a is in four countries Mainly Russia China India and South Africa and in each of these countries and all over the world actually But specifically there we are implementing and only to those patients who need it So you will limit it to distribution to the government. We train the institutions using it We make sure that the come come the the complementary medicines are available and with that We have very strong guidelines on how people can get access to it Yes or no much often to the the disappointment of broader hospitals We want to get simple access to it But if we don't use it in that way the drug can in the in can induce resistance and therefore be unusual Unuseful in the in the next few years Zyrturo The incentives for Zyrturo to a certain extent worked We had an accelerator review voucher But as we applied a tiered pricing to Zyrturo 30,000 in the US 3000 in the develop in the developing emerging countries like Russia 900 in developing countries with 40,000 patients treated. It's absolutely not a viable business model but still the combination of the Access of patients with an incentive of an accelerated review voucher made us doing it and and and I think it's It's absolutely from a human perspective the right thing to do today 40,000 patients who who had a very high risk of dying were able to get the access to the drugs in a mortality drastically reduced in those patients bring us to the point now that we will develop another Two or three new mechanism of action for TB to get to fully new regimens and hopefully to short and and very effective regimens What it also does to get to new drugs it also protect the health care workers X the RTB is a very dangerous disease where you typically need three to six months isolation in the various challenging circumstances May step in for the benefit of our live stream audience We're talking about various forms of tuberculosis just to make to make very clear for you how important This work is not everybody might be familiar with the previous X the RTB is type of tuberculosis which is resistant to almost every drug and It's very difficult to treat and therefore people if it is transmitted You are untreatable and therefore people are in isolation for three to six months by shortening isolation and curing more people the risk for the health care population health care Workers It uses but we can do better so we have to have two or three new new regimens needed for TB and Will we are working on that but as a conclusion what's important to add new AMR We need to build a sustainable ecosystem between the academic discovery the end the institutions who do and who sponsor research the industry the regulators and the Implementers and that all has to work together in a collaborative way in order to bring the medicines bring them to patients to the right patients But then also for us as an industry you have to do this in an for profit System we will have to work together on what are the incentives for more companies to step in in order to make new antimicrobials New antimicrobial drugs for this spectacular challenge in the world Thank you Paul and Jeremy Your work with a welcome with a welcome trust You're working very closely with the private sector as well and with pharmaceutical companies So from your perspective and I know and those of you have been watching for a couple of years You know that Jeremy comes back every year and says indeed This is a disaster waiting to happen and there needs to be more work done So in this case how big is the problem for your perspective and and what does your work with a private sector look like? Yeah, I wouldn't like to be classified as an unending pessimist But you at the start of it you've got to frame the challenge Paul's framed it beautifully for Tuberculosis my own background last 18 or so years was living in Vietnam seeing that on a daily basis And whilst Paul is right that in some countries XDR Untreatable untreatable tuberculosis patients are isolated the truth is in most parts of the world Untreatable to be tuberculosis patients are walking around Talking to you serving you coffee Driving your bus in the morning. That's the truth of it Maybe that here in Switzerland those patients would be isolated, but in most of the world They're not and this should not be framed as an issue only for low-income countries The truth is that the whole of modern medicine depends on being able to control and treat infections So perhaps the most exciting area of medicine at the moment immunotherapies for cancer That is impossible unless you can control infection So this is something that has to bind the world together This is the equivalent in my view of medicine of climate change and the impacts on health This is not something just that happens in places that I've previously worked in this is happening here in Davos today There will be a patient in the hospital today in Davos that has an untreatable or very difficult to treat infection So that's the challenge and two years ago I think we were really not on the starting blocks for how to deal with this and I pay huge tribute to the foundation for running this access To anti-marital curable agents and also to some enlightened governments I think the British and the Dutch government increasingly the German government the US and Increasingly interestingly India and China are stepping up to the plate and saying this cannot go on and we need to Step up and make a difference here I came through as an early doctor untreatable HIV and that is really difficult to manage as a community as a patient as a family And what have you so that is the challenge we face and we could easily go back into that areas But two years on from when we were here first what has happened? things like this access Brochure have come out and it sets a benchmark it sets a benchmark for where industry is It allows industry to hold itself to account and it allows the public to hold industry to account Governments have stepped up the UK government's push through at the United Nations General Assembly So the world is now talking about this issue Well contrast along with barter in the US established car becks to try and encourage and incentivize early push on this and Some governments are starting to think about how incentives can pull through whether the voucher model that Paul talked about or other Incentives so I think that companies are starting to step up new entrants are coming into the field People who are not previously in this space are now trying to look at this space Companies are sheep-like in some way Paul and they will go where the opportunity is and where the money is as well young academics Young academics will go to areas where they think they've got a career And if we make this area exciting and successful then I think new academics will go into that as I did 30 or so Years ago, so I do think there are things to celebrate. We're not there yet We don't have the new antibiotics that we need We are not good enough yet at preserving the ones we have and academia has not stepped up to use the ones We have in the best way, but companies are there governments are there Philanthropy is there and actually I do feel Optimistic that we will be able to turn the tide on this in the next couple of years Thank You. Jeremy Julian. We heard high praise. I think Jeremy used the term enlightened government I was recently in London to visit the welcome trust and and on the taxi ride from there from the airport to the welcome trust I think I heard three times a radio spot saying don't use antibiotics if you don't need them But let's let's hear from you. What else is the new government UK government doing to to work on these issues? Thanks girl, and I'm delighted to be here representing the British government And I think I mean as Paul said this is a disaster waiting to happen I think as Jeremy said this is like climate change in that the threat really only manifests itself over years and decades I think the estimate is that by 2050 there'll be 10 million deaths because of antimicrobial resistance unless unless action is taken unless action is taken now And that is the challenge of the political challenge with climate change is the political challenge with airmar the action needs to Be taken now by governments today So I'm delighted that Sally Davis our chief medical officer has made this such a priority for the British government over recent years working particularly with the Dutch with the Swedes with the Germans and with others and We have been putting this on the agenda for the G7 for the G20 We were very pleased to not just in the World Health Assembly in terms of an action plan But also in the UN General Assembly in 2016 to make this an international priority We've also been putting money behind this we've put 250 million pounds behind a Fleming fund which is allowing us to work with Priority countries around the world to tackle how they handle antibiotics because it comes down to actions taken by by millions of people by thousands of organizations by hundreds of governments in order to tackle this globally and Working internationally is is essential to that, but I'm I think particularly Proud to be here today when we're hearing about how 30 major farm suitable companies are now engaging like Johnson Johnson on this on this AMR benchmark that's been developed by the by the access to medicines Foundation, which is about how best practice in terms of research and development in terms of waste management in terms of marketing which is an essential part of tackling this We obviously hope to see more companies joining and engaging with the benchmark particularly those Dealing with animal health because this is an area where it'll be critical if we're to really meet this challenge And the other critical area that where we as a government want to work with the private sector and want to work through the G7 The G20 in particular is on this area of developing new Antibiotics and how one puts in place the incentives the regulatory structures that actually encourage companies like Johnson Johnson to put The enormous resources into developing new antibiotics, which is also a critical part of this response to this decades-long challenge I mean, it's clear that this challenge can't be tackled without the involvement and leadership of the major International companies and major farm suitable companies and that's why we think today's announcement is so important and so encouraging Thank you. Thank you, Julian and just as a reminder for everybody who's watching or is here in the room Remember that the magic mountain Davos used to be a place where tuberculosis patients actually came to to be cured Hopefully by the by the wonderful Davos mountain air. Obviously we need better treatment than than that because That didn't turn out so well tuberculosis is still is still a massive problem. Jay has been a bit shy Maybe Jay show it the the report is available here and copies in the room But also for all of you on the live stream. It's available on on the website Maybe you want to mention the address for our folks watching? Yes. So the the access to medicine foundation website is WWW dot access to medicine foundation dot org and from that you'll get access to how the industry is doing on on Tackling the issue of AMR tackling issue of access to medicine globally and all other reports So that would be a good thing. Thank you very much and Julian you mentioned already. We hope that more companies more companies join Jeremy Paul What's your message to your peers here in Davos? Both on the public and the private sector. What what's the most important thing they need to do now? I think we have taken the first initiatives on More collaborative work together on how can we we do it faster by learning from each other, but also do Do new clinical trial systems and working with the regulators and discussing on how we can how we can move this faster So we can work as an industry we can work on bringing more molecules into development With the regulators in order to accelerate the the clinical development getting them to patients That's step one So if we need more molecules it have to come out of science to development to regulators to the market and then together with With society the countries in particular will have to work on how do we implement this in a way that it's Sustainable both for the country for the first for the molecule that for the drug for the new drug But also for the countries and industry on how can we make the sustainable on the long term having many new drugs coming through and Making sure that we can treat each and every each and everything each and each buck in the in society Yeah, I agree with that. Obviously. I mean I think the role of philanthropy like ourselves and many others Is we can act as a neutral space that brings together parts of this community that may not otherwise talk to each other And there are tensions that exist. We know that And I think philanthropy has got a critical role in funding the fundamental science and then being a bridge between society and The companies and governments and I think that's the role we play just in my analogy with climate change What which I feel very strongly about climate change as well It's really critical to understand that this is not something that's going to happen to your grandchildren This is happening now and there's an urgency of today that we need to grasp I think that would be my message to Paul's peers and the last bit I'll say is I don't think in this space We have yet galvanized society sufficiently Everybody knows about issues around cancer and oncology and rare diseases amongst Babies and young children. This doesn't have a societal push at the moment. That was absolutely critical in HIV He was absolutely critical in other diseases And we've got to try and work out how we engage Society better in order that the push comes from society for this to happen because ultimately most politicians do listen to society in some way or other And Jeremy you're in agreement there with our co-chair Fabiola Gianotti The the director of CERN who spoke this morning in the co-chair's press conference to that topic and said we can't take science for granted and and Governments especially need to to understand that this needs continuous support and they need to step up the work and I think Julian Your government is leading by example here And that is great to see we have a couple of minutes left Let's see you show of hands if we have any questions in the room if you could Give us an indication. We have a microphone here. I Know the first question is always The most difficult one don't be shy you pick journalism as a profession you shouldn't be shy Well, it looks like you've answered all the questions to everybody's Happiness So, thank you very much for being here. Thank you very much for speaking to this important topic today And as I said there's there's copies of the report and please visit the website Thank you very much. Thank you