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AMR Threat: will antibiotic resistance send us back to the medical dark ages?

Antimicrobial resistance (AMR) is a global threat to public health which fails to receive the attention warranted for the danger posed in coming years. As the Government seeks to push UK life sciences to world-leading status, we examine what action plan is in place and what can be done.

Antibiotic resistance forms a subset of AMR, specifically applying to bacteria that become resistance to antibiotics. This resistance occurs naturally across all microbes such as fungi, viruses and bacteria through genetic mutation overtime. However, the wide and extensive use of antibiotics across the globe has encouraged a significant rise of these mutations, which have begun to render some antibiotic treatments ineffective.

The latest figures available estimate that 1.2 million people died from antibiotic resistant bacteria in 2019.

At this stage, the impact of AMR is relatively new and failing to turn enough heads to devise an effective plan to combat its rise. However, the issue is growing, largely due to the increased prescription and dispensing of antibiotic drugs in developing countries and the overuse of treatments around the world. In developed countries, resistance is broadened through patients failing to finish their treatment – allowing bacteria to form a resistance to antibiotics when it should be killed.

The real danger lies in that antibiotic resistance is going to rapidly increase in coming decades, providing a scary and bleak future for public health. As the number of antibiotic resistant bacteria grows, the global pharmaceutical market cannot produce enough treatments to stem the issue. Soon, previously treatable infections will be untreatable and routine medical procedures could lead to life threatening scenarios.

As we emerge out of the Covid-19 pandemic, a new public health crisis is on the horizon – only this crisis doesn’t take over news channels or dominate government agenda.

Global threat

The World Health Organisation (WHO) has published and adopted a global action plan on AMR that seeks to improve awareness and understanding of antimicrobial resistance and employ use of antibiotics correctly. Essentially the WHO aimed to create an urgency across nations to recognise the potential of the issue.

The World Health Organisation (WHO) has published and adopted a global action plan on AMR that seeks to improve awareness and understanding of antimicrobial resistance and employ use of antibiotics correctly. In reality, these objectives have failed to create any tangible success. In reality, these objectives have failed to create any tangible success.

The reaction from a public health standpoint has indeed been fairly non existent in the UK. Although advice has come from Public Health England (PHE), who have urged people to tackle AMR by taking the advice from clinicians to only take antibiotics when needed.

Isabel Oliver, former Director of National Infection Service at PHE said:

“We want the public to join us in tackling AMR – listen to your GP, pharmacist or nurse’s advice and only take antibiotics when necessary. It’s worrying that more infections are becoming resistant to these life-saving medicines. Taking antibiotics when you don’t need them can have grave consequences for you and your family’s health, now and in the future.”

Government’s action plan

Most recently the Government published the UK 5-year action plan for antimicrobial resistance 2019 to 2024. The plan essentially acknowledges the global problem that AMR possesses and forms part of the 20-year vision on tackling the issue of growing resistance. It includes 15 ‘content areas’ underpinned by actions to combat AMR. These targets include:

• to halve healthcare associated Gram-negative blood stream infections;
• to reduce the number of specific drug-resistant infections in people by 10% by 2025;
• to reduce UK antimicrobial use in humans by 15% by 2024;
• to reduce UK antibiotic use in food-producing animals by 25% between 2016 and 2020 and define new objectives by 2021 for 2025; and
• be able to report on the percentage of prescriptions supported by a diagnostic test or decision support tool by 2024.

Frustratingly the document acknowledges the starkness of the issue at hand but gives no insight into how these targets will be achieved or what realistic steps can be implemented. The UK, like most nations, is confronting this issue independently. If the world is going to confront and tackle AMR, countries have to work to an international agenda united against a common problem.

Final thought

In reality, the Government’s action plan really fails to scratch the surface of the issue and doesn’t align with international objectives. The policy being developed has no implementable solutions and joins a long list of strategy formulated without action. The WHO have aimed to spread awareness of the issue, but currently it seems the governments and the public are unaware of the imminent danger. Unfortunately, it seems concerted action against AMR will only truly begin when widely used treatments are rendered ineffective.

The UK life sciences sector showed its potential to harness innovation and align perfectly to overcome a public health crisis. To achieve its Life Sciences Vision, the Government should lead and address the imminent danger of AMR as it clearly has the potential to do.

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