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Coalition Calls for Testing to Tackle Threat of Antimicrobial Resistance

antimicrobial

A new coalition of industry and health charities, led by former Health Minister, Maggie Throup MP, raise the alarm over missed opportunities to tackle Antimicrobial Resistance in the UK.

Action urgently needed to adopt point of care diagnostics and end years of delay in implementing key recommendations for antimicrobial stewardship.

A cross-sector coalition of health and diagnostics organisations are calling for urgent action to combat the imminent threat of antimicrobial resistance (AMR). Led by the British In Vitro Diagnostics Association (BIVDA) and the former Health Minister, Maggie Throup MP, who was responsible for the roll out of the COVID-19 vaccine, the coalition is highlighting missed opportunities to use proven diagnostic technology that can help to reduce prescribing of antibiotics when they are not needed.

Deaths in the UK related to AMR are estimated to stand at 12,000 per year, the equivalent of deaths from breast cancer each year, and more deaths than from suicide (approx. 6,500). Ten million people each year are predicted to die globally from AMR by 2050 unless urgent measures are taken.

Unnecessary antibiotic prescriptions are a significant factor in causing AMR. Whilst there are simple point-of-care tests that can be used to reduce unnecessary antibiotic prescriptions, these tests are not routinely funded in community and primary care settings. The cross-sector statement urges action in the short, medium and long term to ensure that health systems prioritise funding and adoption of point-of-care testing.

Antimicrobial Resistance

Antimicrobial resistance (AMR) has been identified as one of the most pressing global challenges we face this century. In fact, the World Health Organisation (WHO) has declared AMR as one of the top 10 global public health threats, and the Government recognises AMR as a threat equal to climate change. In 2019 there were 4.95 million deaths associated with bacterial AMR across 204 countries, and 1.27 million of those were directly attributed, leading the WHO to declare it a top global public health threat. 

The NHS sets out the following steps as being necessary to tackle AMR:

  • early prevention of infections 
  • timely, accurate diagnosis 
  • appropriate prescribing and use of antimicrobials only when there is an infection for which they are the most appropriate treatment 
  • effective management of infections 
  • development of alternatives to current antimicrobials 

The use of diagnostics is key to the first four of these steps. This consensus statement sets out clearly how the NHS can achieve this and begin to save money and lives. The statement specifically recognises the immediate impact that C-Reactive Protein testing (CRP) at the point of care (POC) can have on antibiotic prescribing by facilitating decisions to exclude patients from unnecessary antibiotic treatments, contributing significantly to the global fight against AMR and improving patient outcomes. 

In alignment with the UK’s 20-Year Vision for Antimicrobial Resistance and the Government’s upcoming 5-Year Action Plan on Antimicrobial Resistance, BIVDA stresses the importance of policies that actively support the uptake of POCT. This includes measures to integrate POCT seamlessly into existing healthcare frameworks.

Responses

Supporting the coalition, former Minister for Vaccines and Public Health, Maggie Throup MP said “I am deeply concerned about the slow progress that has been made to support the use of point of care tests as part of the UK’s antimicrobial stewardship efforts. AMR is a tremendous threat, and it is critical that we don’t miss opportunities to slow the progress of resistance. That is why we are calling on the government to prioritise the effective adoption of point of care testing in community and primary care settings. The pandemic underlined that the government and health system can move quickly to roll-out diagnostics and respond to major health threats – we must act now, with the same urgency, to tackle the problem of AMR.”

Coming together to set out a call to action for government and the NHS, the cross-sector coalition has expressed concern over the extended delays to implementing key recommendations on using point-of-care tests to tackle AMR. Helen Dent, Chief Executive of BIVDA, commented “It has been almost 8 years since the O’Neill Review made its findings on using rapid diagnostics to tackle AMR and very little progress has been made since then. It’s imperative that we use everything at our disposal to tackle AMR – and that must start with the technologies that are available right now to help reduce unnecessary antibiotic prescribing. COVID-19 gave a blueprint for rapid action – it shows there is no excuse for the long delays in implementing recommendations that can help slow the progress of AMR.”  

CEO of Antibiotics Research UK, Jonathan Pearce, commented: “Antimicrobial resistance is a major health crisis requiring national and international action. But beyond the numbers, there are already many people battling life-altering infections daily in the UK. Tragically, some face premature, preventable deaths. It’s vital we explore all options to address AMR, including only using antibiotics when they are needed, so that they will be there to save more lives in the future. Urgent government action is needed to protect antibiotics for future generations.”

Alastair Buxton, Director of NHS Services at Community Pharmacy England, noted that “Community Pharmacy England is keen to explore how the Pharmacy First service can be expanded to provide more support for patients, while maintaining excellent antimicrobial stewardship. Proof of concept pilots have already demonstrated that community pharmacies can safely and effectively provide C-Reactive Protein testing using POCT technology, so a logical development would be piloting community pharmacist management of lower respiratory tract infections.”

Susanne Emmerich, Associate Director Medical Affairs, Rapid Diagnostics at global healthcare company Abbott, said: “Antimicrobial resistance is recognised as a national chronic risk in the UK; and doctors, nurses and pharmacists are well-aware of the impact it has on making the most treatable conditions and illnesses, untreatable. Tools, such as rapid diagnostic testing, can help professionals on the front lines make informed decisions in a matter of minutes and reduce unnecessary prescribing of antibiotics. However, despite the introduction of initiatives such as Community Diagnostics Centres, Acute Respiratory Infection Hubs and Pharmacy First, they are not as widely used as they could be. While horizon scanning can help to identify new innovations to support our fight against AMR, we must also consider tools already available and look to remove barriers.”

Paul Ko Ferrigno, CEO of éclateral, a bio-electronics company, commented: “Academics and SMEs up and down the country were inspired by the O’Neill report to devise new tests, many of which are now approaching market readiness. The lack of guidance on point-of-care testing for bacterial infections is creating uncertainty for investors and there is a risk that without the investment needed to get tests through regulatory approvals, many promising innovations will be left in the infamous ‘valley of death’ that separates the R&D lab from patients. This investment will be unlocked as soon as there is a clear market pull with a commitment from government for increased POCT testing.”

You can read the consensus statement here.

BIVDA are available for comment or interview. Please send all media enquiries to pressoffice@bivda.org.uk.  

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