Together with cardiovascular diseases, infectious diseases are the most common cause of death worldwide. Infections are caused by bacteria, viruses, fungi or parasites. Epidemics like Ebola reveal how dangerous these pathogens are.

We have known about the effects of antibiotics since the discovery of penicillin: They prevent bacterial growth or even destroy bacteria. The problem is that bacteria can defend themselves against antibiotics. They can become resistant. Multiresistant pathogens are a particular threat to health. Today’s antibiotics are unable to combat them effectively, which leads to longer and more severe infections or even death. The 2016 O’Neill report estimates that by 2050 antimicrobial resistance (AMR) could result worldwide in up to 10 million deaths per year if no comprehensive counter-measures are taken.

Success requires joint action

The international community is aware of the danger posed by multiresistant pathogens. We must now firmly address this global challenge in a joint effort. Antimicrobial resistance has therefore been a priority of Germany’s G20 leadership and is on the agenda of Argentina’s 2018 G20 presidency.

What can we do to combat multiresistant pathogens or prevent such multiresistance in the first place? Researchers can make valuable contributions by working to produce new effective antibiotics that are needed to combat multiresistant bacteria. At the same time, we need to improve our understanding of how resistance develops and spreads among bacteria. This is the only way to develop effective strategies to prevent increasing resistance.

Research can help

The Federal Research Ministry (BMBF), the Federal Ministry of Health, the Federal Ministry of Agriculture and numerous relevant associations jointly drafted the German Antibiotic Resistance Strategy in 2008. The main objectives of this strategy are to prevent the occurrence and spread of multiresistant pathogens and improve precautions against hospital infections. The focus is on the prudent use of antibiotics to treat humans and animals.

The BMBF contributes to the Strategy by supporting various research projects under different funding priorities:

InfectControl 2020 is a highly innovative research collaboration between research institutes and industrial companies. They are developing fundamentally new strategies for early detection, combatting and successfully controlling infectious diseases and resistant pathogens.

The German Centre for Infection Research (DZIF) brings together the expertise of excellent infection researchers throughout Germany. “Healthcare-associated and antibiotic-resistant bacterial infections” and “Novel anti‑infectives” are two of the Centre’s fields of work. They focus on research into antibiotic resistance and controlling the spread of such resistance and on the development of novel methods for prevention and treatment.

The CSCC Centre for Sepsis Control and Care in Jena is one of eight Integrated Research and Treatment Centres in Germany funded by the BMBF. It deals with the control and care of sepsis, a disease caused by bacteria.

The clinical infectiology research group at Jena University Hospital is carrying out research on resistant pathogens.

International cooperation as the key to success

The Federal Government is convinced that the challenges of multiresistant pathogens can only be tackled effectively through internationally coordinated efforts. During Germany’s G20 presidency, the heads of state and government decided in summer 2017 to strengthen cooperation in the fight against resistant pathogens worldwide. The BMBF then initiated and coordinated the set-up of the Global Antimicrobial Research and Development Hub (Global AMR R&D Hub). The kick-off event took place in spring 2018. The members of the initiative, which include the countries Russia, China, USA and France and the European Commission as well as funding organizations such as the Bill and Melinda Gates Foundation, the Wellcome Trust , convene meetings at regular intervals. They identify critical research and development tasks and jointly coordinate how to utilize their resources. The aim is to provide even more effective funding for the research and development of new therapies and diagnostics against resistant pathogens.

Interested countries and relevant non-governmental donor organizations can become members of the Global AMR R&D Hub. Other stakeholders are encouraged to participate by contributing their specific expertise. The Global AMR R&D Hub networks with international initiatives to utilize synergies and pool expertise. These initiatives include for example the European Joint Programming Initiative on AMR (JPIAMR) and the Global Antibiotic Research & Development Partnership (GARDP).

Transmission between humans and animals

Livestock breeding is another area where antibiotics are used and where multiresistance occurs. Resistant bacteria can be transmitted from animals to humans or vice versa through direct contact or the consumption of animal products. The BMBF is funding one collaborative research project within the national research network on zoonotic infectious diseases in which physicians and veterinarians study the transmission of resistant bacteria from humans to animals: One Health Interventions to Prevent Zoonotic Spread of Antimicrobial Multidrug-Resistant Bacterial Microorganisms – #1Health-PREVENT.