19 May 2016

Antimicrobial Resistance: A Call to Action 

Antibiotic resistance could kill ten million people a year by 2050, a stark government report has warned.

Lord Jim O’Neill, former chairman of Goldman Sachs has set out his final report on the global challenge of resistance to commonly used drugs.

Lord O’Neill was commissioned by David Cameron in 2014 after dire warnings that drug resistance would send modern medicine back to the dark ages, making routine operations too risky and even minor scratches life threatening.

The report recommended:

  • An urgent global awareness campaign by summer 2016.
  • Financial incentives for pharmaceutical industry to produce new drugs.
  • Roll out of rapid tests to allow doctors to identify infections in real time.

The final review echoed several high-profile warnings including Dame Sally Davies, the UK Chief Medical Officer, who described the threat as “catastrophic” and Chancellor George Osborne who said drug resistance could become a bigger killer than cancer.

NICE guidance on antimicrobial stewardship highlights the importance for healthcare professionals to only prescribe antibiotics when they are needed. Doctors need to give the right antibiotic, at the right dose to the right patient.

Professor Mark Baker, Director of the Centre for Clinical Practice at NICE, said:  “We need to encourage an open and transparent culture that allows health professionals to question antimicrobial prescribing practices of colleagues when these are not in line with local and national guidelines and no reason is documented.”

“It’s not just prescribers who should be questioned about their attitudes and beliefs about antibiotics,” continued Professor Baker. “It’s often patients themselves who, because they don’t understand that their condition will clear up by itself, or that perhaps antimicrobials aren’t effective in treating it, may put pressure on their doctor to prescribe an antibiotic when it is not indicated and they are unlikely to benefit from it.”

Lord O’Neill said in his review a better supply of new drugs was key to overcoming antimicrobial resistance (which includes antibiotics, antivirals and antifungals). He recommended better financial incentives be given to the pharmaceutical industry to encourage the development of new antibiotics and other drugs. A new class of antibiotics has not been made available in decades.

Lord O’Neill, Chairman of the review on AMR, said: “My review not only makes it clear how big a threat AMR is to the world, with a potential 10 million people dying each year by 2050, but also now sets out a workable blueprint for bold, global action to tackle this challenge. The actions that I’m setting out today are ambitious in their scope – but this is a problem which it is well within our grasp to solve if we take action now.”

Lord O’Neill also called for fast and accurate diagnosis of patients meaning they receive the most effective treatment for them and reduce improper use of medicines. This would slow down the development of resistance and ensure drugs remained effective for longer.

He said the specialised diagnostic technology needed to be made available across the world.

Prudent use of antibiotics would increase their lifespan however between 2010 and 2014, prescriptions rose in primary and secondary care, the sharpest rise of which was in hospitals. Consumption in general practice increased by 6.2%. And prescribing to hospital inpatients climbed by 11.7%.

Lord O’Neill’s final review built on eight interim reports assessing how we can best tackle AMR globally. It placed emphasis on enhancing public understanding and reducing the use of antimicrobials in agriculture.

Professor Baker said: "Drug resistance is often spoken about as if it is a future concern, a problem we are yet to face. This is not the case. It is happening now.

"For too long we have gazed into the future making predictions of worst case scenarios and quoting alarming death rates in the millions by 2050. There are people who will die today because the drugs they need no-longer work. We need to act now. Our guidance says the right drug should be prescribed at the right time to the right patient and it provides details of how to identify this. Further work is in train.

"This final report chaired by Jim O’Neill brings together all of our current understanding. It can provide both the knowledge and financial framework we need to launch a cohesive international effort to combat drug resistance.

"The time for talking is over. This review should be read as a call to action.”