Driving access to antibiotics in Malaysia

Dr Helmi bin Sulaiman had carefully tended to his patient at the University of Malaya, Malaysia. He treated the man for life-threatening bacterial infections in his liver and bloodstream, and then a resistant infection in his lungs, using available treatment options. 

But now the infection had returned. Two bacteria had been found in the patient’s blood, and Dr Helmi and his team believed that there were only a handful of existing antibiotics—either in late-stage development or recently approved—that could save the patient’s life.  

Malaysia is located in Southeast Asia, one of the regions hardest hit by antibiotic resistance. According to a recent study published in The Lancet, the number of deaths caused in 2019 by drug-resistant infections in that region (including Southeast Asia, east Asia and Oceania) was 254,000—that is, nearly 1/10 of the deaths caused by drug-resistant infections globally that same year.  

When faced with extensively resistant infections—such as infections that do not even respond to “last-resort” antibiotics—Dr Helmi doesn’t have much choice.  

“We have to resort to therapies that have high rates of failure,” said Dr Helmi. “I dream of having better alternatives, even a range of options, to deal with these horrific organisms.” 

For the patient with infection in his blood, Dr Helmi sought special permission known as “compassionate use” to treat the patient with a recently approved antibiotic that is not currently registered in Malaysia. It took over three weeks and ~USD3,000—or about 25% of the average annual income per person in Malaysia—to have the product flown in from Europe. With the first dose, the patient began his long recovery. Finally, nearly five months after checking into the hospital, the patient walked out of the hospital infection-free.  

“This compassionate use programme has helped us a lot,” said Dr Helmi. “But it doesn’t solve the problem: I do not have access to the right medications.” 

Now Dr Helmi is among clinician-researchers around the world who are using every avenue available to them to get their patients access to appropriate treatments at affordable prices. He is engaging with the Ministry of Health and contributing to clinical trials of new antibiotics to help bring new treatment options to his patients. He is also raising awareness about the lack of access to antibiotics that limits treatments for patients in Malaysia.  

“The dystopian future is not far-fetched. We already have pockets of outbreaks that are happening in Malaysia. There’s no time to worry about outbreaks of drug-resistant infections. We deal with them every day. They are right in front of us. It is happening now,” said Dr Helmi 

People keep on talking about driving antibiotic pipelines. But the truth is that the pipelines of new antibiotics do not extend to us in Malaysia. If I can start the conversation by sharing my experience, I am more than happy to help,” said Dr Helmi.  

Expanding antibiotic access to all people is central to GARDP’s mission. To learn more, visit https://gardp.org/access-to-antibiotics/