The UK Secretary of State for Health, Matt Hancock, spoke last week at the World Economic Forum in Davos about the urgent need to tackle AMR, announcing a 20 year plan to reduce the use of antibiotics in humans and animals, along with a raft of funding allocated to new research. What particularly caught the eye was recognition that there needs to be a new way to bring biopharmaceutical companies to the cause. Such companies already invest many times more than governments and philanthropic organisations do in drug development - they are absolutely part of the solution to the AMR crisis. However, the economic incentive for novel drug development is poor. The initial upfront cost of research and development is vast, and only a small percentage of promising compounds ever make it through that are proven to be safe and effective. Once a new drug hits the market, there is a narrow window during which intellectual property rights allow the company to recoup the cost of development and seek to make a profit before patents expire. Add into this mix the rise of AMR, where good stewardship encourages us to limit the use (and therefore sales) of antibiotics to only the cases when they are most needed - the model does not encourage investment and innovation in novel drug development. Hence we have seen company after company vacate the field to focus on other pharmaceutical products.

What Matt Hancock has proposed is that companies be paid for antibiotics based on their value to the National Health Service. Proposals also include market entry awards, and reimbursements for unsold antibiotics. These ideas may uncouple profit from unit volume sales, and revolutionise the economics of drug development.

I have read several comments in the media following this event that the UK is a relatively small country, that AMR is a global problem that does not respect borders, and that any effort we make, however well intentioned, is so trivial as to be almost inconsequential. I would like to highlight the impact a small economic nudge has made to our usage of plastic bags in Europe. Since 2010, the amount of plastic bags recovered from the seabed in part of the North Sea has declined by around 30%, coinciding with the introduction by many European countries of the nominal plastic bag charge. Yes, the UK is a relatively small country, but if this new initiative proves a successful case study for other countries to adopt, then the ripples may yet have global impact.