‘Antimicrobial resistance: the biggest health challenge of our time’

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Without urgent action, antimicrobial resistance (AMR) could end modern medicine as we know it. This would have a devastating impact on patients and their families and carers, the NHS, the economy and on global health security. No government will be able to overcome this challenge on its own, but the UK has an opportunity to lead global efforts to tackle AMR.

What is antimicrobial resistance?

Antimicrobials are a category of medicines used to prevent and treat infections. They include antibiotics, antivirals, antifungals and antiparasitics. Antibiotics have been a pillar of modern medicine for over a century. They treat once-fatal infections and underpin healthcare across our entire life course, from childbirth to common surgeries and life-saving treatments like chemotherapy. There simply can be no functioning healthcare system without effective antimicrobials. 

Bacteria naturally become resistant to antibiotics over time, but this has been accelerated by factors like their overuse in healthcare and agriculture, increased travel and poor access to clean water and sanitation. AMR disproportionately impacts low- and middle-income countries, which may not have the policies, infrastructure and resources to tackle this challenge. Resistance is not bound by country borders, meaning a lack of progress to reduce AMR in one part of the world can hinder progress in another.

Why is action on antimicrobial resistance important?

The Covid-19 pandemic showed us the long-term impact of an infectious disease that initially had no effective treatment. Healthcare systems across the world, including the NHS, are still struggling to recover from its impact on patients, waiting lists and the healthcare workforce. AMR is a global health crisis that needs to be similarly prioritised, learning from the experience of Covid-19 and working to predict and prevent AMR where possible.

The number of antimicrobial resistant bacteria is growing. Without action, these bacteria could cause ten million deaths a year globally by 2050. This surpasses estimated global deaths from major diseases by 2050, including cancer (8.2 million per year) and diabetes (1.5 million per year). In 2020, more than 90,000 people were admitted to NHS hospitals in England due to antimicrobial resistant infections. The cost of AMR to the NHS was estimated to be £180m in 2018 – this is set to increase at pace without intervention. By 2050, an estimated $100trn in global economic output will be at risk due to antimicrobial-resistant infections.

People with antimicrobial-resistant infections report devastating and long-term impacts on their physical and mental wellbeing, social and family life and ability to work or volunteer. “Daily life for me is a struggle. I feel incredibly unlucky. Since my operation, I now suffer from near constant pain, immense distress and worry, major disruption to my life and damage to my mental health.” Ronda’s story with thanks to Antibiotic Research UK

Challenges and opportunities in the fight against AMR

We risk running out of effective antimicrobials to treat resistant infections. Concerningly, few new antimicrobials are in development. As of 2021, there were only 43 new antimicrobials in clinical trials, compared to the 1,800 trials for immuno-oncology medicines in 2020. This is partly due to the high cost and risk of failure for manufacturers, which disincentivises investment. 

However, as demonstrated by the world-leading NICE/NHS England pilot, there is appetite for schemes that can guarantee future revenue following successful antimicrobial development (known as a ‘pull incentive’). We hope to see a UK-wide purchasing approach that will support the future availability of effective antimicrobials and meet the commitments on AMR pull incentives in the 2021 G7 finance ministers’ statement. 

It is vital that policymakers hold the line on AMR, amidst the distractions of a UK general election. The UK must seize the opportunity of the upcoming five-year AMR national action plan, the proposed antibiotics subscription model and the UKRI £30m investment into antimicrobial innovation to cement its global leadership in AMR. Current and future governments must recognise the urgency of AMR and prioritise implementation of the national action plan, with dedicated funding and accountability measures, whilst ensuring the subscription model is fit for purpose.

Daniel Zeichner MP and chair of the APPG for life sciences said: “Labour has pledged to ensure that our NHS is fit for the future as one of its key missions in government. Effective antibiotics are the cornerstone of modern medicine and an essential part of having an efficient, well-functioning NHS. It is vital that we address antimicrobial resistance so that we can have a sustainable source of these medicines.”

You can read more about the ABPI and its work here.