Taiwan facing rising health threat from antibiotic resistance: Experts

Taipei, June 7 (CNA) Antibiotic resistance has become a serious public health issue in Taiwan at a time when the country could soon face the possibility of running out of effective antibiotics to treat infections, infectious disease experts said Saturday.

"The global threat of antibiotic resistance has impacted not only the international community but also Taiwan," Wang Fu-der (王復德), president of the Infection Control Society of Taiwan, said at a press conference in Taipei on Saturday morning.

He appealed for more antibiotic drugs to be developed domestically or for the domestic health care system to pay higher drug prices to entice foreign pharmaceutical companies to make their more advanced antibiotics available in Taiwan.

Though Wang was not able to quantify the current or near-term threat created by bacterial resistance to antibiotics, he cited studies estimating that antibiotic resistance could cause up to 33,000 deaths and economic losses of NT$300 billion (US$10 billion) in Taiwan in 2050.

But one particular threat that has already arisen in Taiwan, according to Wang, was carbapenem-resistant enterobacteriaceae (CRE) -- a group of bacteria commonly found in hospitals across Taiwan that is resistant to the carbapenem class of antibiotics.

CRE was one of the most critical threats that appeared on the World Health Organization's updated Bacterial Pathogen Priority List last year, Wang said.

Citing data from the Centers for Disease Control, Wang said 30.3 percent of intensive care unit patients in medical centers in Taiwan were infected with CRE in the third quarter of 2024, up from 15 percent in 2015.

The rising figure, along with other related indicators, shows that Taiwan is facing "a serious antibiotic resistance problem," he said.

Echoing Wang, Chang Feng-yee (張峰義), president of the Infectious Diseases Society of Taiwan, said that only a few antibiotics remain available as last-line treatment options in Taiwan, which are insufficient to meet clinical and patient needs.

He said that treating infections caused by multidrug-resistant bacteria requires new antibiotics, but Taiwan has fewer treatment options available compared to Western countries, presenting "a major challenge."

"Delayed treatment for drug-resistant bacterial infections can lead to higher mortality, with studies showing a sharp increase in death rates if appropriate antibiotics are not given within 72 hours," Chang said.

To address the issue, Wang said the government should support local pharmaceutical companies in developing new antibiotics, as most are currently focused on generic drugs and lack the capacity for original antibiotic research and development.

Introducing new antibiotics developed overseas is also a solution, Wang said, but Taiwan's relatively low drug prices -- mainly regulated by the National Health Insurance (NHI) system -- have discouraged international drug companies from entering Taiwan's market.

"Taiwan is considered a relatively small market, so most companies prioritize entering the Chinese market first, where drug prices tend to be more favorable than in Taiwan," he said.

In the same vein, Chang told CNA that Taiwan's NHI system is internationally known for its "strong bargaining power" with pharmaceutical companies, meaning it tends to drive down drug prices in order to maximize cost-effectiveness.

If pharmaceutical companies were to accept a low price in Taiwan, it could lead to pressure to lower prices in other countries as well, Chang said, explaining why many are unwilling to bring new antibiotics to the Taiwanese market.

"Many companies would rather give up the Taiwanese market, which is why having reasonable NHI drug prices is so important," he argued.