Successful antibiotic cooperation being led from Uppsala University

Enrico Baraldi is project manager for PLATINEA: "We saw the need to create a better dialogue between health care and industry in order to give real priority to the most important antibiotics".

“We have brought together skills and knowledge about antibiotics and identified which measures ought to be prioritised,” says project manager Enrico Baraldi, Professor in Industrial Engineering and Management at Uppsala University.  

Antibiotic resistance is a growing threat to public health and is a focus for research projects worldwide. But at the same time, the systems behind the manufacture and distribution of antibiotics continue to suffer from a lack of efficiency and, in particular, poor communication between industry and health care systems.

This is something that the PLATINEA platform aims to change. The Vinnova-financed project started in 2017 and is now in its second phase which is focusing on cooperation. It engages 16 partners from academia, industry, health care and government agencies. Uppsala University is coordinating the project under the direction of Enrico Baraldi, a professor at the Department of Civil and Industrial Engineering.

“The role of Uppsala University in this platform is important in many respects. First of all, the University is perceived as an independent party, which can really help to create neutral ground for the health care system and the industry to meet on. Our experience is also that it is better if more universities are involved because they have knowledge that complements what Uppsala University has – in our case the Karolinska Institutet, and the Universities of Gothenburg and Linköping.”

Research excellence in Medicine and Pharmacy

The initial phase of the project identified specific antibiotic needs and gaps in knowledge about the effects of antibiotics. Today, participants at these universities, the Karolinska Hospital and Uppsala University Hospital are working on clinical and preclinical studies to increase knowledge about the use of older antibiotics. New evidence is being developed that could lead to improved procedures in the health care sector, for example in antibiotic dosages.

Another of the actors involve in PLATINEA is the Public Health Agency of Sweden, which has made an inventory of which studies ought to be prioritised.

“For example these might be studies of urinary tract infections in pregnant women that no one has wanted to study because there is no money to gain from it. However, improperly used antibiotics can cause severe side effects such as loss of bacterial flora and a compromised immune system. This constitutes great suffering for many women,” says Enrico Baraldi.

PLATINEA has only secured funding for a few of the studies that would need to be carried out; a more comprehensive survey might therefore be delayed for five to ten years. The intervention studies currently in progress in several hospitals around Sweden also risk having to be postponed as time and resources need to be allocated to patients with COVID-19.

Knowledge of supply chains and industrial systems

Another area of focus for PLATINEA is access to antibiotics. Value and supply chains have turned out to be vulnerable, particularly during the pandemic. A year ago, however, PLATINEA published a report presenting a solution in the form of antibiotic buffer stocks. In the event of fluctuations in demand or delivery problems, these stocks would lie above the current inventory levels and ensure that there is a buffer in the system. PLATINEA’s proposal was recently submitted to the Ministry of Health and Social Affairs.  

“It is a very simple solution,” says Enrico Baraldi. “The structure doesn’t have to change significantly, you just need to identify where to create these buffer stocks. And it’s not about creating the kind of defence stockpiles we have had in the past and hiding them in a mountain cavern. These stocks should be in the system and able to be activated in just 2-3 months. It’s just for the regions and various actors in the health care system to make the decision and ask suppliers to systematically increase these buffers.

Identifying key variables and proposing concrete measures are some of PLATINEA’s strengths; in addition, there is a process for reaching agreement despite the different interests of industry, the health care system, and government agencies, according to Enrico Baraldi. The participants in the platform have developed a mechanism for continuous open dialogue on various incentive models.

“Take, for example, payment systems, where we are fully aware that for many of these pieces of the puzzle to fall into place, it will require huge changes in regulation. PLATINEA could play the role of an advisory body. But so far we are only at the cooperation stage. Implementation will hopefully come in the next phase.”

Applying for continued project support

In April 2021, the second phase will be concluded. PLATINEA hopes to then receive funding from Vinnova for Phase 3, the implementation phase. The participants will then ensure that the results obtained in Phase 2 can be disseminated and applied. The project would then continue for another two years.

“Ultimately, we want what is done within the framework of PLATINEA to have a social benefit that arises out of what industry, academia and sometimes the health care system do together. It might sound rather idealistic, but from what I have seen, the actors involved have so far followed this principle,” says Enrico Baraldi.  “We have built a structure where we try to balance everyone’s perspectives in the decisions made, and in the knowledge, evidence and results that are produced.”