International Report States Global Collaboration Needed to Fight Antimicrobial Resistance

With reports in the mainstream media prophesizing doom with regard to the issue of antimicrobial resistance—and specifically the ability of currently available and approved agents to treat certain infections—a committee formed by the British government has released a report designed to properly contextualize the crisis and develop recommendations for addressing it.

The Review on Antimicrobial Resistance (RAMR), which released its report in May, includes representatives from academia (i.e., clinical and basic researchers), healthcare providers, pharmaceutical manufacturers, and public health officials. These experts note that approximately 700,000 people worldwide die from resistant infections annually and that, by 2050, this figure could increase to more than 10 million, and result in losses of hundreds of trillions of dollars in economic output.

“Antibiotics are a special category of antimicrobial drugs that underpin modern medicine as we know it: if they lose their effectiveness, key medical procedures such as gut surgery, caesarean sections, joint replacements, and treatments that depress the immune system, such as chemotherapy for cancer could become too dangerous to perform,” they write. “Tackling antimicrobial resistance is core to the long-term economic development of countries and our well-being. Solutions to address it must have global access to healthcare at their heart and they must help us to stop wasting medicines that we rely on and yet are exhaustible.”

Efforts by Contagion to reach the authors of the report prior to press time were unsuccessful, and it is too early to tell how the RAMR analysis and recommendations will be received by government officials in the United Kingdom (according to the RAMR web site, the organization reports directly to the prime minister). However, it’s worth noting that while the RAMR’s suggested approaches are hardly novel, they do reaffirm ideas proposed by other entities, including the World Health Organization and the US Centers for Disease Control and Prevention, and highlight the significance and severity of the problem.

In summary, the RAMR recommendations include the following:

1. A “massive global public awareness campaign” targeted such that “patients and farmers do not demand, and clinicians and veterinarians do not prescribe, antibiotics when they are not needed.”
2. Initiating efforts to “improve hygiene and prevent the spread of infection… by expanding access to clean water and sanitation” and/or [reducing incidence of] infections in health and care settings… [through] proper hand washing,” among other strategies.
3. Reducing “unnecessary use of antimicrobials in agriculture and their dissemination into the environment” by setting goals for reducing use of antibiotics in food production in general, restricting the use of certain “highly critical” (in other words, the last line of defense) antibiotics, and improving transparency in food production.
4. Improving “global surveillance of drug resistance and antimicrobial consumption in humans and animals.” (In 2015, the UK government responded to an early RAMR recommendation on this issue by allocating $375 million (US) toward the creation of a surveillance system.)
5. Promoting “new, rapid diagnostics to cut unnecessary use of antibiotics.”
6. Establishing a Global Innovation Fund “for early-stage and non-commercial research” to bolster supplies of new antimicrobials and instituting financial incentives to “promote investment for new drugs and improve existing ones.”

For these efforts to succeed, RAMR urges the creation of “a global coalition for real action, via the G20 and the UN.” They estimate that the costs for implementing their recommendations would be approximately $40 billion (US) over a 10-year period.

“It is in policy makers’ and governments’ hands to take steps to change this situation,” the RAMR notes. “Because microbes travel freely, some of the steps that are required will need to be taken in a coordinated way internationally. What is certain is that no single country can solve the problem on its own and several of our proposed solutions will require at least a critical mass of countries behind them if they are to make a difference.”

Brian P. Dunleavy is a medical writer and editor based in New York. His work has appeared in numerous healthcare-related publications. He is the former editor of Infectious Disease Special Edition.