On August 30, 2024, I had the opportunity to hold a speech at Oulu University’s FRONT research program on resilience about a project I have started and been dealing with for the last eight years or so. This project, called Platinea, is not a typical research project, but a collaboration platform involving academia, industry, healthcare providers and public authority, all working together to address a common problem afflicting Sweden, namely lack of access to and inappropriate use of antibiotics.
Antibiotic resistance is a global challenge which is making antibiotics unable to treat common diseases. The problem is further aggravated by misuse and lack of access to old still functioning antibiotics. Sweden, like many other small countries, regularly experience antibiotic shortages and withdrawals, causing patient suffering and substantial healthcare costs. Moreover, even the best specialists lack knowledge of how to use optimally old antibiotics, especially those introduced before modern clinical trials. To make things worse, key stakeholders like industry providing antibiotics and healthcare professionals did not talk to each other about the most needed antibiotics or supply changes, a growing problem in increasingly fragile supply chains.
In November 2016, a first meeting was held bringing together representatives from academia, healthcare and industry to explore possibilities to improve communication and understanding between these sectors, which previously had been kept separate for fear of conflicts of interests. Now, instead, it appeared clear that an open dialogue and closer collaboration were essential to address the common problem of lack of access and misuse of antibiotics. This was the start of Platinea, which went in three years from four to 18 partners, further growing to currently 21.
An important moment was when a central Swedish public agency joined Platinea, with its strong competence and mandate to represent key public health issues, including prioritized knowledge gaps on antibiotic use and the most critical antibiotics with risk of shortage. In this way the needs of healthcare could be manifested and communicated for other stakeholders to act upon. This needs-driven approach became Platinea’s basic model to select, fund and perform a series of clinical and preclinical studies to optimize the use of specific antibiotics, followed by implementation studies to support the introduction into medical practice of their evidence. Platinea’s overarching goal is now to bring the right antibiotic to the right patient in the right dose and at the right time. To achieve this, it is essential to improve access, reduce shortages and avoid market withdrawals of important antibiotics. Therefore, we dedicated important efforts within Platinea to identify first the causes of lack of access and then to devise together a set of policy-related solutions to address these causes. This was a challenging but exciting work involving as many as 40 people from all four sectors of academia, industry, healthcare and public authority, which generated a commonly agreed list of 10 prioritized policies, ranging from increased inventories to new reimbursement models with fixed yearly payments. It is a great pleasure to see that several of these 10 policies developed within Platinea are now discussed by the Swedish government and other public agencies for possible implementation.
Platinea was born and operated during its first five years or so mostly nationally within Sweden. However, since 2022 and especially the Swedish EU Presidency in 2023, we started discussions with EU agencies and other countries dealing with antibiotic access issues and interested in Platinea’s model and proposed policy solutions. In particular, there are clearly important collaboration opportunities among the Nordic countries, as they all face recurrent antibiotic shortages and withdrawals: potential joint policies will be discussed during 2024 in the frame of the Nordic Ministers Council.
Platinea has been for me a very stimulating journey where I combined my role as founder and project manager with that of social science researcher. As an academic researcher I am particularly interested in interorganizational relationships and networks. But my new role as project manager enacting policies to “preserve the value of antibiotics” has also reoriented my research focus into understanding how policies can change networks to make them more resilient and able to create value in more sustainable ways. Then, this can likely turn into a never-ending project, at least in terms of my research interest in this topic.
The Exploring resilience blog discusses the current themes of research, teaching and development of resilience, i.e., crisis resistance and deepens knowledge about the management of global change, and possible solutions to the wicked problems of sustainability. The authors are researchers and experts in the field, and members of the cooperation networks of the University of Oulu’s FRONT PROFI7 research programme.