Having chaired the independent (and global) Antimicrobial Resistance (AMR) Review for David Cameron, I know a similar approach should have been taken quickly about COVID-19.
Similar not in precise nature but – in so far as incorporating infectious disease modelling, and using economic analysis to try to contain and solve it – it should be applied in parallel.
The AMR Review is well-known for highlighting the potential loss of life as well as the economic costs of an escalating growth of resistance to antimicrobials, and the inaction to prevent it.
In particular we showed that, by 2050, there could be around 10 million people each year dying from AMR, and an accumulated $100trn economic cost to the world from 2015 to 2050.
What is less focused on, as we showed in our final report, is that to prevent these horrendous outcomes, a ‘mere’ $42bn would need to be invested globally. This would give an investment return of something like 2,000%.
I shudder to think what policymakers could do if we don’t make these investments and we reach a situation – possibly accelerated itself by escalating the inappropriate use of antibiotics in this COVID-19 crisis – where we run out of useful antibiotics. It will be a much longer time period to find new vaccines to beat COVID-19.
In addition to this crisis, requiring G20 policymakers to back up their generous words about combatting AMR would mean they need to spend around $10bn instigating the generally agreed Market Incentive Awards to promote serious efforts by pharmaceutical companies.
In fact, given that the financial crisis we are also now in means companies are greatly dependent on our governments for their future survival, perhaps the pharma Industry will finally understand the real world concept of ‘Pay or Play’, where companies that don’t try to find new antibiotics are taxed to provide the pool of money for others that are bold enough to try. And realise there is a world coming of different risk-rewards for all, including them.
When applied to the COVID-19 challenge, it is useful to look at the required investment in accelerating as much as possible the efforts to find useful vaccines to beat it, but also to immediately introduce the therapeutics and diagnostics in countries that are so poorly prepared.
Those Asian countries affected early include a number that seem to have coped so far in keeping the crisis to a minimum because they had the appropriate therapeutics and diagnostics, despite not having vaccines. A sum of approximately $10 bn from the G20 would be sufficient to cover all these vital areas.
Now consider the economics of social distancing. As soon as it became apparent that our policymakers were heeding the Chinese method of trying to suppress COVID-19, it was immediately obvious that our economies would – at least for a short period – sustain the collapse of GDP that China self-imposed in February. From industrial production and other regular monthly data, the Chinese economy has declined by around 20%.
It is quite likely many other economies – probably each of the G7 countries – will experience something not too dissimilar in March. And, to stop our complex democracies from further immediate pressure including social disharmony, governments in many countries have needed to undertake dramatic unconventional steps.
Here in the UK, our new chancellor effectively had three budgets within less than a fortnight. And outside of the £330bn loan policy he has announced, at least £50bn worth of economic stimulus has been announced.
Many other G20 countries have undertaken their own versions of what I call ‘People’s QE’, many of them bigger packages – the US appears to be contemplating a stimulus as much as $2 trillion.
But, for the sake of illustration, if the UK package were the price for three months social distancing and this was repeated across the G20, then the total cost for all G20 countries – adjusted for relative size – would be in the vicinity of $1trillion.
If this isn’t accompanied by steps involving the best therapeutics and diagnostics, and we have to keep everyone isolated for one year, it would become at least $4trillion.
This may be ‘back of the envelope’ calculations which ignores the almost inevitable challenges for social cohesion in so many nations. But the G20 must spend something around $10bn immediately to put in absolute best standards all over the world, and another $10 bn to kickstart the market for new antibiotics.
Jim O’Neill, Chair, Chatham House.
This is a version of an article that first appeared in Project Syndicate.