AMR needs to be 'top five' priority for UK government, report suggests

Antimicrobial resistance (AMR) needs to become a ‘top-five policy priority’ by the UK government if the virtual loss of modern medicine is to be stopped, a new report has said.

A report from the Health and Social Care Committee highlights the severity of the situation, stating that “rapid progress” needs to be made and that “strong, visible political leadership is urgently needed.”

Drug-resistant infections currently kill around 700,000 people every year but by 2050 this figure is expected to rise to 10 million, if current trends continue.

In particular, more effort is needed by the pharmaceutical industry with the report suggesting a number of government/industry initiatives to encourage pharmaceutical companies to develop new antibiotics.

These include the “Play or Pay” scheme suggested by Lord Jim O’Neill, in which an investment would be paid by pharmaceutical companies unless they are participating in antibiotic research and development.

Other suggestions include changes to patent laws and upfront payments to drug companies who develop new antimicrobials, helping to ensure at least some level of profitability for the manufacturer.

Profitability is a major concern for pharmaceutical companies and is one of the reasons why no new classes of antibiotics have been developed for over 30 years.

Pharmaceutical companies struggle to see the commercial appeal of developing new antibiotics, the report states. This is due to the way in which antibiotics are sparingly prescribed and the unpredictable nature of emerging resistance.

Dr Sarah Wollaston MP, Chair of the Committee said: “In six months we want to see tangible progress on implementing practical policies to reverse the worrying exodus from AMR research and development and both government and industry should play their part in tackling this issue."

More so, whereas the Government has increased investment into AMR over the past five years, the number of pharmaceutical companies that are developing new clinical trials to take antimicrobials to market has reduced, with the latest company to exit the market being Novartis. Indeed the total number of pharmaceutical companies currently involved in developing new antimicrobial treatments stands at six.

Despite efforts to encourage research and development into new antimicrobial treatments, changes in the use of antibiotics within healthcare is essential, with the report highlighting the need to “preserve” existing antimicrobials.

This can be achieved through measures to control the spreading of infections within and outside of hospital settings and also through reducing the number of antibiotic prescriptions.

Prescription rates for antibiotics in the UK are double those in the Netherlands, Sweden and Baltic states, the report states. And whilst there has been a reduction in prescriptions of 13% in primary care over the past five years, secondary care has not witnessed consistent reduction.

The report also suggests that digital health tools could “dramatically help reduce” the treat of AMR. However the uptake of best practice is varied across the NHS. Therefore, a single organisation should be responsible for ensuring clinical decision support systems are co-ordinated, the report states.

An updated AMR strategy from the government is due to be published in early 2019. The Health and Social Care Committee is calling on the government to implement the recommendations set out in its review.

The AMR Centre, which worked alongside life science groups Bionow, LifeArc and OneNucleus, in submitting its concerns to the Select Committee, welcomed the report.

Dr Peter Jackson, executive director of The AMR Centre, said: “We welcome the Select Committee recommendations today, which reflect many of the concerns featured in our industry group submission. The Government’s updated AMR strategy is due to be published early in 2019, and this is a key opportunity to renew the impetus for tackling this extremely serious threat.

“The Government’s five-year AMR strategy (2013-2018) called for a new supply of safe and effective antimicrobial drugs, but the UK’s current translational capability is under invested, and not yet adequately powered to provide a sustainable pipeline of life-saving medicines to treat AMR.

“Our submission called for an urgent and co-ordinated plan of action across pharma companies, SMEs, government, investors, philanthropy and academia to significantly increase investment in the translation of new AMR programs, in particular to target the World Health Organisation’s critical priority superbugs.”