Applied Microbiology International (AMI) has welcomed the UK government’s new national action plan on antimicrobial resistance to protect people and animals from the risk of drug-resistant infections.
The plan to tackle antimicrobial resistance, a global issue that makes infections difficult or impossible to treat, was launched today (8 May 2024).
AMI chief executive Dr Lucy Harper responded to the announcement, saying: ”AMI welcomes this step by the UK government to tackle AMR, an urgent global challenge which threatens the effectiveness of antibiotics, leading to increased mortality, prolonged illness, and a rising burden on healthcare systems worldwide.”
The national action plan will commit the UK to reducing its use of antimicrobials - such as antibiotics, antifungals and antivirals - in humans and animals, strengthen surveillance of drug-resistant infections before they emerge and incentivise industry to develop the next generation of treatments.
It commits to continue to innovate through initiatives such as indicating that that the world-first ‘subscription model’ for antimicrobials, which was launched in 2019 as a pilot, could be expanded. This will see more companies paid a fixed annual fee for antimicrobials based primarily on their value to the NHS, as opposed to the volumes used.
20-year vision
The plan will build on progress towards the UK’s 20-year vision for antimicrobial resistance, which will see AMR contained, controlled and mitigated - protecting public health by increasing the risk of disease spread, severe illness, disability and death.
Health Minister Maria Caulfield said: ”Almost 8,000 people in the UK die from drug-resistant infections every year. If this continues to spread, common infections and injuries that were once easily treatable become harder, and in some cases impossible, to treat.
”Our 5-year action plan outlines our commitment to leading the way in tackling AMR, including through expanding our world-first subscription model to accelerate research into new treatments.
“In a world recovering from the profound impact of the COVID-19 pandemic, international collaboration and preparedness for global health challenges have taken on an unprecedented level of importance.”
National action plans
This is the second of a series of 5-year national action plans that will ensure sustained progress by tackling the global threat of AMR.
Learning from the achievements and challenges faced in delivering the previous plan, which was launched in 2019, this new national action plan will run from 2024 to 2029. It embeds lessons from the COVID-19 pandemic and will include specific commitments focusing on infection prevention and control, and the development and use of diagnostics and vaccines.
Action has already been taken across sectors, including the medical and farming industries, to decrease the number of infections and prevent AMR from spreading.
Strategic outcomes
The new plan has 9 strategic outcomes organised under 4 themes:
- Reducing the need for, and unintentional exposure to, antimicrobials - this includes activity to prevent infections arising in the first place (through good infection prevention and control, including vaccination), to monitor the emergence and spread of AMR through strengthened surveillance, and to minimise release of antimicrobials and resistance into the environment.
- Optimising the use of antimicrobials - through ensuring antimicrobials are only used when needed in humans, animals and the environment.
- Investing in innovation, supply and access - by supporting and incentivising the development of new vaccines, diagnostics and therapeutics (including alternatives to antimicrobials), making them accessible to those who need them, and ensuring our work on AMR is informed by cutting edge research.
- Being a good global partner - maintaining the UK’s role as an international leader on AMR and supporting low and middle income countries to respond to the threat of AMR through research, good supply chains and access to antibiotics.
Developing resistance
AMR occurs when bacteria, and other microorganisms, develop resistance to antimicrobial drugs, such as antibiotics, making them less responsive or unresponsive to treatment. Avoiding unnecessary antibiotic usage in humans and animals is crucial to slowing the development and spread of antibiotic resistance.
In 2022, the government invested £210 million to partner with countries across Asia and Africa to tackle AMR and reduce the threat posed to the UK, through the Fleming Fund.
It is estimated that in 2019, 1.27 million deaths globally were caused by infections resistant to antibiotics. The UK is committed to playing a central role in the global effort to confront AMR by taking a comprehensive approach that leverages the country’s expertise and domestic experience.
Scale of threat
The scale of the AMR threat, and the need to contain and control it, is widely acknowledged by governments, international agencies including the World Health Organization and World Bank, researchers and private companies alike.
Chief Medical Officer Professor, Chris Whitty, said: ”Antibiotics are one of the most powerful tools we have against infection. Resistance to these drugs therefore poses a significant threat to the lives of many people in the UK and around the world.
”AMR is not just a matter for clinicians - it is important to work across sectors to help preserve these vital medicines to minimise the impact of AMR.”
Antibiotic emergency
UK Special Envoy on AMR, Dame Sally Davies, said: ”It is incomprehensible for any of us to imagine a world without effective antibiotics.
“But we are facing an antibiotic emergency already. And this menace is deeply unfair - with the burden disproportionately falling on the world’s most vulnerable, in low and middle income countries and also children.
“We have to work together, across the world, with those countries that need action the most, to make progress and contain AMR.”
Collective action
Professor Susan Hopkins, Chief Medical Adviser at the UK Health Security Agency (UKHSA), said: ”Antimicrobial resistance is a threat to all of us - simple lifesaving interventions in the form of antimicrobials are in danger of becoming ineffective.
“Through our priority AMR programme, including One Health surveillance, collaborative working with the health service, international collaborations and novel approaches to therapies and diagnostics, UKHSA has risen to meet this active threat - but it will take collective action across government, industry, academia and the public to ensure that antimicrobials remain available for ourselves and our communities, now and in the future.”
Invisible threat
The Deputy Prime Minister, Oliver Dowden, said: ”AMR is the invisible threat we must tackle to protect the welfare of our society and safeguard the NHS.
“I am pleased to see the publication of this second national action plan, which fulfils our commitments in the Biological Security Strategy to progress towards the vision of a world where AMR is effectively contained, controlled and mitigated by 2040.”
UK Chief Veterinary Officer, Christine Middlemiss, said: ”The UK has made fantastic progress in the past 10 years to reduce AMR in animals, working between government, farming industry, vets and animal keepers to reduce the use of antibiotics in food-producing animals by more than half.
“The new national action plan will build upon these achievements, and I urge vets and animal keepers to continue to support the UK’s 20-year vision to contain and control AMR.”
Setting a precedent
Richard Torbett, Chief Executive, Association of the British Pharmaceutical Industry, said: ”AMR is a pressing health challenge which requires urgent global action. The UK has been proactive in finding practical solutions to this problem, and this new national action plan sets a precedent that countries worldwide should follow.
“Expanding the pilot of the innovative antibiotic subscription model is a crucial next step with our industry’s full support. This type of innovative thinking is needed to address the issues associated with AMR and safeguard public health from this shared threat.”
Continuous pipeline
James Anderson, Executive Director, Global Health at the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) and Chair of the AMR Industry Alliance, said: ”Tackling the rising threat of AMR will depend on having a continuous pipeline that delivers new, innovative antibiotics.
”To do this, society needs to take bold action to redefine the value we place on them and attract more R&D investment.
The successful results of the UK’s pilot programme provide an important reference point ahead of this year’s UN high-level meeting on AMR. As a truly global challenge, we need to see countries working together to make a step change in how the world is addressing AMR.”
Professor Sir Stephen Powis, NHS National Medical Director, said: ”Effective antibiotics are fundamental to providing the best care and treatment for patients both in the NHS and globally, so it is only right that we move to tackle the major issue of antibiotic resistance.
“We welcome this new strategy by the Department of Health and Social Care, as the NHS continues to lead the world by developing a new subscription-style payment model to create greater incentives for new antibiotics to help tackle this issue, with both national and global partners.”
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