Govt Issues 5 Year Plan to Tackle Antimicrobial Resistance

Peter Russell

January 24, 2019

Antimicrobial resistance is as big a danger to humanity as climate change, Matt Hancock, the Secretary of State for Health and Social Care, said as he launched a response to the growing problem.

The Government has set out a 5-year action plan to contain, control, and mitigate against antimicrobial resistance by 2040.

Mr Hancock launched the proposals at the World Economic Forum in Davos.

Some of the plan's focus would be on giving drug manufacturers financial incentives to develop new antibiotics to tackle resistant strains, and further reducing inappropriate use of antibiotics in patients and animals.

The 2016 independent review, chaired by Lord O'Neill, predicted that antimicrobial resistance would kill 10 million people every year by 2050 unless action was taken. It warned that a lack of effective antibiotics would render straightforward, everyday operations such as caesarean sections or hip replacements too dangerous to perform.

'A Threat We Cannot Afford to Ignore'

Today's government response, Contained and Controlled , said antimicrobial resistance was already estimated to cause at least 700,000 deaths around the world each year. If it went unchecked, it would come at a huge cost, not only in financial terms, but also in terms of global health, food security, environmental wellbeing, and socio-economic development.

Johnjoe McFadden, professor of molecular genetics at the University of Surrey, commented: "The crisis is threatening to turn curable into incurable diseases and has the potential to return us to the pre-antibiotic era when patients could die of infections that are today considered trivial.

"Much needs to be done to prevent this catastrophe, including providing changes in prescribing practices, improvements in hygiene and restrictions on the use of antibiotics on the farm; but also supporting research to develop new antibiotics able to tackle resistant strains."

At the launch of the Government's plan, the Prime Minister Theresa May said: "The increase in antibiotic resistance is a threat we cannot afford to ignore."

Antibiotics in the UK

Between 2014 and 2017, the UK reduced human antibiotic use by 7.3%, and sales of veterinary antibiotics have fallen by 40% since 2013.

However, organisms that cause many common diseases such as tuberculosis, HIV/AIDS, malaria, sexually transmitted infections, urinary tract infections, chest infections, bloodstream infections, and food poisoning, can resist a wide range of antimicrobials. Some cases of tuberculosis and gonorrhoea are already resistant to antibiotics of last resort.

Drug-resistant bloodstream infections have increased by 35% from 2013 to 2017.

For most antimicrobials, few replacement or alternative products were under development, the response noted.

Among the Government's plans were:

  • Cutting the number of drug-resistant infections by 10% (5000 infections) by 2025

  • Reducing the use of antibiotics in humans by 15%

  • Preventing at least 15,000 patients from contracting infections as a result of their healthcare each year by 2024

The useful life of current antibiotics could be extended by encouraging clinicians to prescribe antibiotics appropriately, it said. They could be assisted by new technology which would gather real-time patient data.

The Government also pledged to work with vets and farmers to further reduce antibiotic use in animals by 25% between 2016 and 2020.

The NHS and the National Institute for Health and Care Excellence (NICE) would help to encourage the pharmaceutical sector to develop new antibiotics by devising a payment system that paid manufacturers according to the value of their medicines to the NHS, rather than on the quantity of antibiotics sold.

Launching the plan, which was developed in collaboration with the devolved UK administrations, Mr Hancock said: "Each and every one of us benefits from antibiotics, but we all too easily take them for granted, and I shudder at the thought of a world in which their power is diminished.

"Antimicrobial resistance is as big a danger to humanity as climate change or warfare. That’s why we need an urgent global response."

Prof Dame Sally Davies, England's chief medical officer, tweeted that the UK government's plans "demonstrated a clear commitment to continue its global leadership in tackling this growing threat".

Dr Jonathan Betts, research fellow at the University of Surrey, commented: "By increasing the resources for research and development of new antibiotics, improved diagnostics, infection control and antibiotic stewardship, it may be possible to avoid a 'post antibiotic era'."

Reaction to the Proposals

The Royal College of GPs said doctors had already made progress reducing the number of antibiotic prescriptions they wrote. Its Chair, Prof Helen Stokes-Lampard, said: "We need to get to a stage where antibiotics are not seen by patients as a 'catch all' for every illness, but rather as a serious drug option, usually reserved for when all other treatment options have either failed or been deemed inappropriate. It's crucial that we continue to get this message out, so that we can carry on delivering safe, effective care to our patients both now and in the future."

She added: "It's also astonishing that there hasn't been a new and approved class of antibiotics produced in over 30 years – there have recently been some promising signs, but it’s clear that more investment in the research and development of new drugs to tackle emerging diseases is desperately needed, and if offering appropriate incentives and NHS collaborations with pharmaceutical companies are demonstrated to safely support this, then they should be encouraged."

The British Medical Association (BMA) said it was concerned that Brexit could undermine international cooperation on the issue, particularly if the UK's relationship with the European Centre for Disease Prevention and Control was compromised. Dr Peter English, BMA public health medicine committee chair, said: "Antimicrobial resistance, like many other threats such as infectious disease outbreaks and climate change, is not confined by borders.

"Cooperation with Europe is therefore paramount to research and surveillance efforts that can better enable us to plan for pandemics and respond to global health threats."

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