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Efforts to combat resistance to antibiotics will fail unless developing countries are included in the battle, a conference heard last week.

Problems that beset poor countries, such as the cost of future antibiotics and their availability, must be tackled in any attempt to find long-term answers  to resistance, delegates from 45 countries agreed at the meeting, held at Uppsala University, Sweden, (6–8 September) and organised by Action on Antibiotic Resistance (ReAct).

They also agreed that global cooperation is urgently needed to slow the spread of resistance by limiting the use of antibiotics — and also to monitor its growth, given that common infections might once again become fatal as bacteria become resistant to current treatments.

Andreas Heddini, executive director of ReAct and a medical doctor at the Karolinska Institute, Sweden, said there had been a "change of tone" at the meeting.

Drug industry representatives acknowledged for the first time that there was a need to tackle issues  in developing countries, he said.

An important step could be restricting the use of the latest or broadest antibiotics in developing countries for conditions that have alternative treatments, said Heddini.

But, to do so, scientists need more community-wide data so they can understand the spread of resistance and, therefore, which drugs need to be prioritised or restricted in which places.

 "So far, only hospital data is available from developing countries," Heddini said, which gives only a partial picture.

Eva Ombaka, former president of the not-for-profit Ecumenical Pharmaceutical Network (EPN), said that scientists in developing countries "can help provide a good indication of what is really happening on the ground" and that mapping the spread of antibiotic resistance around the world needs their input.

Delegates discussed the need for new models of private–public cooperation to work towards new classes of antibiotics that do not rely on investment by pharmaceutical companies in search of high-profit, branded drugs.

To this end, Heddini said a number of working groups have been set up that will meet over the next two years. The efforts will emulate existing partnerships in malaria and tuberculosis drug innovation, including the Open Source Drug Discovery programme, which might cut research and development costs while still delivering new drugs.

Earlier this year the Transatlantic Task Force on Antimicrobial Resistance (TATFAR), set up by the European Union and the United States in November 2009, published its terms of reference on investigating antibiotic resistance issues.

It was criticised by ReAct and others for not including developing countries in its remit.

But Stuart Levy, director of the Alliance for the Prudent Use of Antibiotics, told SciDev.Net: "That the United States and Europe have come to the table on this issue is an important first step. Finally, the urgency has been recognised, which might lead to more funding for seeking solutions.

"I don't want this to fail because of political issues."

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