Infectious diseases, Italy under fire: two national plans at the forefront in Europe to stop them

Vaccination coverages below the critical 95% threshold. Europe’s highest prevalence of HCV infection, estimated at about 1 million people. Italy black jersey for antibiotic resistance of bacteria such as klebsiellae And more than 280,000 people affected by care-related infections.

In addition to the 5 million people infected each year by influenza.

The threat of infectious diseases, viral and bacterial in origin, at centerpiece of the event

AHEAD – Achieving HEalth through Anti-infective Defense, sponsored by MSD Italy.

But the Italian health care system is showing great responsiveness and innovation through choices at the forefront of Europe, such as the National vaccine prevention plan,

with one of the widest supply in the world, and the Plan against antibiotic resistance, the launch of which is imminent. Fundamental goal of ensuring uniform access across the country to vaccines and innovative drugs against hepatitis C and resistant bacterial infections.

There is influenza, which affects about 5 million people in Italy each year. Pneumonias, often associated with influenza, with about 200.000 cases per year and 10.000 deaths, and meningitis. Herpes Zoster, which along with influenza and pneumococcus forms the so-called “cursed triad” that threatens older people. There is hepatitis B and C with hundreds of thousands of chronic carriers. Multidrug-resistant bacterial infections that affect 7% to 10% of patients each year with thousands of deaths.

Also, Papillomavirus infections that can cause anogenital cancers. Believed to be eradicated or under control, with a lower mortality rate than cancers and cardiovascular diseases, infectious diseases, whether bacterial or viral in origin, are actually among us more than ever.

Today, in Rome, during the event AHEAD – Achieving HEalth through Anti-infective Defense, promoted by MSD Italy, representatives of institutions, regulatory authorities, patient associations and clinicians take stock of the strategies our country is deploying against infectious diseases, showing a great capacity for innovation, thanks to choices at the forefront in Europe, such as the National Vaccine Prevention Plan, approved earlier this year, and the Plan against antibiotic resistance, whose launch is imminent.

“Infectious diseases still represent a significant chapter in terms of incidence and mortality in Italy“, says Walter Ricciardi, President Superior Institute of Health (ISS). “Italy is black jersey in terms of resistance of germs such as Klebsiellae and other Gram-negative bacteria to several antibiotics, first and foremost carbapenems. But even preventable viral diseases, such as influenza, can indirectly cause thousands of deaths each year from bacterial or cardiovascular complications. Infectious emergencies then constitute a case apart, and the meningitis case in Tuscany and outbreaks of chikungunya or West Nile represent just a few of the many episodes we are forced to face each year“.

The advance of infections is aided by declining coverage in Europe and Italy for almost all vaccinations, some of which have fallen below the safe threshold set at 95 percent, putting at risk the so-called “herd immunity,” which protects those who cannot vaccinate or infants.

A great opportunity to curb this phenomenon is the National Vaccine Prevention Plan 2017-2019, linked to the new Essential Levels of Care, which has increased vaccine supply and made vaccines accessible without co-payment.

“The new National Vaccine Prevention Plan 2017-2019, approved in the State-Regions Conference on January 19, 2017, identifies effective and homogeneous strategies to be implemented throughout the country, giving wide emphasis to ensuring the active and free offer of priority vaccinations for the age groups and populations at risk indicated. Vaccine supply now is extensive and among the most advanced in the world“, says Ranieri Guerra, Director General Health Prevention, Ministry of Health.

The next challenge is the uniform implementation of the new Plan in all Italian regions to ensure equitable access to vaccines for all citizens. “We judge positively the expansion and goal of uniformity in the supply of vaccines, which finally reduces inequalities in terms of opportunity among citizens in our country. The challenge is for this opportunity for health protection through vaccines to become a reality for all: for this we must ensure the effectiveness of the implementation of the contents of the Plan, improving the organization of services and ensuring the necessary efforts to achieve the coverage“, he continues Francesca Moccia, Deputy Secretary General Cittadinanzattiva.

Another open front is hepatitis C virus (HCV) infection, a global epidemic with a prevalence of about 180 million chronically infected people. Italy is the European country with the highest prevalence of HCV, with about 1 million carriers of the virus. Recently the World Health Organization announced the goal of eliminating hepatitis globally by 2030, and all the governments of industrialized countries-Italy in the lead-are taking steps to do so.

Elimination of hepatitis C passes through access to next-generation antiviral therapies that can eradicate the virus in the majority of cases.

“Not using the therapeutic options that science makes available to eradicate one of the most widespread and insidious infections such as HCV is an unacceptable choice on a health, social and even ethical level: the time has come to give certainty to all HCV-infected patients, eliminating all barriers for access to new therapies through a National Plan aimed at the complete eradication of this disease“, says Federico Gelli, Member XII Committee on “Social Affairs,” House of Representatives.

If the advance of infectious diseases of bacterial origin has found a wall in the past 70 years, that wall has been antibiotics. But in recent years, antibiotic resistance, that is, the ability of bacteria to resist antibiotics, has grown to become a dramatic problem. By 2050, antibiotic-resistant infections could be the world’s leading cause of death, taking an annual toll of more than 10 million lives. In Italy, antibiotic resistance remains among the highest in Europe.

In our country, Care-Related Infections (CAIs) affect an estimated 284.100 patients causing no less than 5.000 deaths.

The response to be made on this other front is through good clinical practice procedures, appropriate use of antibiotics by introducing the concept of stewardship, that is, the possibility of rationalizing the use of antibiotics, and the search for new antibiotic therapies that can defeat resistant bacteria. Principles guiding the Plan against antibiotic resistance to be launched in the spring.

“The Plan National against antibiotic resistance, announced in recent days by Health Minister Beatrice Lorenzin. is going in the right direction Not to return in a few decades to the pre-antibiotic era and pre-penicillin deaths: the qualifying aspect is the choice to address all aspects of antibiotic resistance in an integrated way according to a ‘One Health’ that is, a holistic approach to human and animal health. Another key aspect is the availability of next-generation antibiotics, which must be made accessible to the patient in accordance with the criteria of proper stewardship“, states Mario Marazziti, President XII Commission on “Social Affairs,” Chamber of Deputies.

At the forefront along with the institutions, in the search for new therapies and the definition of proper antimicrobial stewardship, is also a pharmaceutical company like MSD, which has written some of the fundamental pages in the history of the fight against infectious diseases.

“MSD has a long history in the treatment of infectious diseases – says Nicoletta Luppi, President and CEO MSD Italy – a history marked by major successes, with the discovery of real milestones that have changed the approach to diseases and, above all, the expectation and quality of life for patients. An area that MSD has always continued to preside over, even when company investments have been directed toward other therapeutic areas. Our efforts aimed at scientific advancement have enabled us to assert our leadership in this field over time, seizing important results in the treatment of infectious diseases of viral origin, such as hepatitis C (a real health emergency, for which giant strides have been made in just a few years and we finally know that, thanks to the latest generation of therapies, a cure is possible) rather than in the fight against cancers caused by the HPV virus.

On the bacterial infection front, MSD is one of the few pharmaceutical groups still active in both human and animal health to promote the adoption of true antimicrobial stewardship through the development of new antibiotics that can combat the phenomenon of antibiotic resistance and the search for new vaccines that can provide concrete answers to unmet health needs in both advanced and developing economies. We intend to reaffirm and continue our commitment against infectious diseases, not only by continuing to research technological innovations in our laboratories, but also by collaborating with all stakeholders involved through transparent and valuable partnerships alongside public health“.