Antibiotic resistance â sometimes known as antimicrobial resistance â occurs when antibiotics become ineffective in treating infections, often due to their overuse or presence in food. Responsible for millions of deaths, it is among the most critical threats to human health. According to the World Health Organization, if left unchecked, it could result in 10 million lives lost annually and $1tn in additional healthcare costs globally by 2050. Yet action to prevent this catastrophic future has been slower than the crisis demands, and most traditional approaches are reactive, risking a âtoo little, too lateâ scenario.
With each passing year, the problem becomes more complex. Several companies dedicated to developing and commercializing new antibiotics have gone bankrupt, and most big pharmaceutical companies have dropped plans to develop antibiotics, unable to find a good business case. Although these corporations have created the $1bn AMR Action Fund to encourage the development of new antibiotics, the fund recognizes that it will not fix the challenges that threaten a sustainable antibiotic pipeline.
Wouldnât it be great if time travel were possible to see whether humanity succeeds in conquering this and other major crises such as climate change and the scourge of plastic waste? Fortunately, there is a kind of time machine available. The Future Back approach is a transformative solution pioneered by Thomas Malnight, Professor Emeritus of Strategy and General Management at IMD, which we are implementing in our teaching to help chart a clear path to overcoming tough challenges such as antibiotic resistance.
The Future Back method allows you to avoid being trapped by current challenges and constraints, instead focusing on the opportunities and innovations needed to shape a more positive future.
This Future-back methodology diverges from conventional problem-solving processes, which start from the present and work toward the future. Instead, you are invited to envision an ideal future outcome â in this case, a world where antibiotic resistance is no longer a critical threat â and then work backward to identify the essential steps, collaborations, and innovations necessary to achieve that outcome. This method allows you to avoid being trapped by current challenges and constraints, instead focusing on the opportunities and innovations needed to shape a more positive future.
The learnings from our sessions on addressing antibiotic resistance are accompanied by an IMD mini case called, âIt is 2033, and antibiotic resistance is no longer a threat. How did we get there?â
Each session begins with a presentation outlining the global antibiotic resistance crisis, which emphasizes the situation’s urgency and explains how existing strategies were insufficient to combat the rapid rise in resistant bacteria.
Participants are divided into smaller groups to facilitate focused discussions, each addressing two key questions: (1) We are in 2033 and succeeded in addressing antibiotic resistance â how did that play out as a timeline? and (2) Who were the main stakeholders involved? Groups are further split into proactive teams, which develop strategies, and reactive teams, which respond to big events that force action. The questions and framing encourage holistic thinking, integrating scientific and medical advances with the political, economic, and societal shifts required to make progress. Teams visually outline their proposed solutions on posters, and each session concludes with a readout, synthesizing group insights and fostering reflection on emerging themes and strategies.
âAntibiotic resistance is not only a scientific problem but also an economic one.â
Our recent Future Back sessions yielded several key insights into the challenge of antibiotic resistance. These lessons helped shape a comprehensive strategy for addressing the issue by 2033.
Antibiotic resistance is not only a scientific problem but also an economic one. Developing new antibiotics is costly, with little financial incentive for pharmaceutical companies to invest. This is because new antibiotics are typically reserved for last-resort use, making them less profitable than medications used more frequently. Overcoming this market failure is crucial to addressing antibiotic resistance. Innovative business models are needed to incentivize new antibiotic research and development investment. This could include public subsidies, government-backed prize funds, or new regulations ensuring companies are compensated for investing in essential but less profitable medications.
While the means to address antibiotic resistance already exist, these efforts require coordination and a proactive approach. Individual countries and organizations need help to solve the problem; global cooperation among governments, pharmaceutical companies, healthcare providers, and civil society is required. Reactive measures, such as responding to crises after they arise, will only increase human suffering and financial costs. Instead, proactive steps â including promoting responsible antibiotic use, strengthening global surveillance of drug resistance, and investing in prevention â are essential.
Despite the costs and challenges associated with antibiotic development, advances in genomics, artificial intelligence, and biotechnology have accelerated drug discovery processes and made identifying novel antibiotics and treatment alternatives easier. AI, for example, enables the rapid simulation of millions of experiments to find new antibiotics. However, technology alone is insufficient; successful implementation requires robust systems, strategic partnerships, and sustainable financial models.
It is increasingly clear that addressing antibiotic resistance reactively â after it has spiraled into a full-blown crisis â would result in staggering costs, both in human lives and financially. The burden of drug-resistant infections, which cause more extended hospital stays and more intensive treatments, would cripple healthcare systems.
The complexity of antibiotic resistance demands system leadership, which involves coordinating multiple sectors and stakeholders toward a unified goal. Strong leadership at national and international levels is necessary to implement the comprehensive strategies needed to combat antibiotic resistance. This includes aligning the goals of the public health sector, regulatory bodies, the pharmaceutical industry, and global organizations like the World Health Organization.
Robust public-private partnerships are among the most promising paths to address antibiotic resistance. The scale of the problem means that governments and private companies need help to solve it. Collaboration between the public and private sectors, supported by global frameworks and agreements, would enable the pooling of resources, expertise, and funding necessary to develop new antibiotics, improve diagnostics, and implement global surveillance systems.
Finally, we recognize the crucial role of crises as catalysts for decisive action. The most positive and fastest outcomes typically arise when triggers, supported by prior preparation and investments, lead to fast and assertive action.
With these insights in hand, we now have a better understanding of what it will take to prevent antibiotic resistance from becoming the global catastrophe it once threatened to be.
While the scale of challenges like the climate and biodiversity crises and antibacterial resistance might feel paralyzing, the Future Back approach fosters a âcan doâ mindset. By focusing on a future where a complex challenge has been successfully addressed, participants can overcome the limitations of current thinking and explore innovative solutions. This mindset fosters a sense of possibility and optimism, encouraging creative thought and bold action, revealing that even seemingly impossible challenges can be tackled with the right mindset and strategic planning.
The road to overcoming antibiotic resistance remains challenging, but the Future Back method allows us to envision a world where this threat has been mitigated and maps out a clear and actionable path for getting there, including the key strategies that address market failures, foster collaboration, leverage technological advances, and enable proactive, preventive actions. The need for strong leadership and public-private partnerships is also a central theme. With these insights in hand, we now have a better understanding of what it will take to prevent antibiotic resistance from becoming the global catastrophe it once threatened to be.
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The fact base of these Future Back sessions was developed out of The Antibiotic Ecosystem Conundrum, an IMD case written by Carlos Cordon, Patrick Itterbeek, Roberto Matta, Inger Anne Torsheim, and Brigitta Vos. We would also like to recognize IMD Emeritus Professor Thomas Malnight as an important inspiration for the Future Back approach.
You can read more about the antibiotic resistance challenge here.
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