01 Jun 2016
Written by Tamar Ghosh
The AMR Review, commissioned by the UK’s Prime Minister and delivered by Lord Jim O’Neill, recently released its final report, recommending a global action plan to tackle the urgent problem of antimicrobial resistance. This final report, following eight interim reports, brings together a need for public awareness, new antibiotics, rapid diagnostics and improved use of antibiotics in animal health and surveillance. Through Nesta, the £10m Longitude Prize is tackling this same issue by rewarding a novel, accurate, affordable and rapid point-of-care test that, globally, will significantly reduce the misuse or overuse of antibiotics. We welcome the AMR Review’s final report and the recommendations made.
In its very first report the Review quantified the cost of resistance, putting the human cost at up to 100 million lives lost per year by 2050, at a cumulative economic cost of around 100 trillion USD. Behind these figures there will be everyday stories of people from all countries and health settings dying from minor infections and of transplants and cancer treatment being refused or unsuccessful. Being able to explain the scale and urgency of this global problem is a hard, but very important, task.
Like the AMR Review we recognise the importance of improved public awareness about antibiotic resistance, namely what it means, why and how it is growing, its impact on our lives, and what we can do about it. Last year the second of our annual UK surveys found that almost a third of people in the UK think antibiotics no longer working is the greatest health threat, up almost 10% on the previous year. We also saw improvements in behaviours such as finishing courses of antibiotics, not pressurising GPs, and not using antibiotics from past prescriptions.
However, like other recent studies, whilst awareness is growing, there is still misunderstanding about when antibiotics are needed, and what resistance means. In addition to our public engagement in the general media and at science festivals and centres, a shared priority with the Review is to reach children and young people. To this end we are soon launching an app-based game to raise awareness amongst 11 to 16 year olds.
We are also delighted that rapid diagnostics featured as an important recommendation in the Review. We recognise the potential improvement in the prescribing or purchasing of antibiotics by health workers, patients and consumers if a rapid diagnostic could be developed. A test that brings together affordability, speed, accuracy and accessibility across health settings to either rule antibiotics use in or out, or help determine which antibiotics should be used, is the agreed ultimate goal of experts we’re working with.
We agree that a ‘step change in technology’ is needed, speeding up the existing pipeline of diagnostics and stimulating novel approaches, by investment in both enticing new ideas and rewarding successful innovations. This is an area we have recently improved by launching the Discovery Awards, to encourage the development of new and existing ideas, including those unable to access funding elsewhere. We expect to see both a winning diagnostic for the Longitude Prize, as well as a number of other diagnostics that will help tackle specific issues of resistance.
The Review also recommends that, by 2020, prescriptions should be informed by diagnostics results, where one exists. In global communities where it may not be possible or desirable to access health workers, we feel this recommendation could potentially be extended to the use of a diagnostic before antibiotics are dispensed in pharmacies and supermarkets; a rapid diagnostic would help many of the channels through which antibiotics are used.
However, we understand this would need a significant change in regulation, as well as government support and funding in some areas. A similar approach of preventing online sales of antibiotics without prescription would also be beneficial. If such an approach were taken, it should be supported by the increased public awareness the Review recommends, to prevent behaviours such as sharing or using previous prescriptions.
In this unique year, when we hope to see resistance to antibiotics discussed at the World Health Assembly, G7, G20 and the UN General Assembly, the final AMR Review is a timely and important call to action. We look forward to working with our teams, partners and supporters to help inspire and encourage an improved global diagnostics pipeline.
