Final report from AMR Review

18 May 2016

Written by AMR Review

Building on eight interim papers, this is the final report from Lord Jim O’Neill’s Review on Antimicrobial Resistance, established by the UK Prime Minister David Cameron in 2014 to avoid the world being “cast back into the dark ages of medicine.”

The costs of AMR

The report sets out why AMR is such a huge problem and that it must be tackled. AMR is a problem that is getting worse. Antimicrobial drugs are becoming less effective and the world is not developing enough new ones to keep up. The global costs if we do not take action now could be 10 million people dying every year by 2050, and a cumulative economic cost of around 100 trillion USD.

How AMR can be tackled

It then sets out 10 areas where the world needs to take action to tackle AMR. Many of these measures focus on how we can reduce the unnecessary use of antimicrobials, and so the rate at which resistance increases, making our current drugs last longer. Others look at how we can increase the supply of new antimicrobial drugs because, even if we reduce unnecessary use, our arsenal to defeat superbugs is running out and needs to be replenished. All 10 areas are important, but four are particularly key:

1) A global public awareness campaign to educate all of us about the problem of drug resistance.

2) The supply of new antibiotics needs to be improved so they can replace existing ones as they become ineffective.

3) We need to use antibiotics more selectively through the use of rapid diagnostics, to reduce unnecessary use, which speeds the incidence and spread of drug resistance.

4) We must reduce the global unnecessary use of antibiotics in agriculture.

How solutions can be paid for

The paper then discusses how these solutions would be paid for. The costs of action are dwarfed by the costs of inaction: the proposals made by the Review on AMR would cost up to 40 billion USD over 10 years. However, the cost of AMR between now and 2050 could be as much as 100 trillion USD. The solutions could be paid for by one or more of the following:

  • Allocating a very small percentage of G20 countries’ existing healthcare spending to tackling AMR
  • Reallocating a fraction of global funding from international institutions to AMR
  • Apply an antibiotic investment charge to pharmaceutical companies who do not invest in research for AMR
  • Implementing a tax on antibiotics
  • Introducing transferrable ‘vouchers’ to reward new antibiotics

Next steps

International collaboration for real action via the World Health Assembly, G7, G20 and the UN is needed to deliver these policy proposals and turn discussions on AMR into action. This needs to build on promising steps made by governments, and by industry recently affirming its commitment to tackle AMR with a landmark declaration at Davos. With this momentum, and 700,000 people already dying every year from AMR, 2016 is a crucial year.


Lord Jim O’Neill, Chairman of the Review on AMR, said: “My Review not only makes it clear how big a threat AMR is to the world, with a potential 10 million people dying each year by 2050, but also now sets out a workable blueprint for bold, global action to tackle this challenge. The actions that I’m setting out today are ambitious in their scope – but this is a problem which it is well within our grasp to solve if we take action now. I call on the governments of the G7, G20 and the UN to take real action in 2016 on the ten proposals made by my Review, to avoid the terrible human and economic costs of resistance that the world would otherwise face.”

Professor Dame Sally Davies, Chief Medical Officer for England, Longitude Committee, Longitude Prize Advisory Panel Co-chair, said: “Lord O’Neill’s final report makes a number of challenging recommendations for the world to adopt if we are able to tackle the growing threat of drug resistant infections. In every international forum, including the G7, G20 and the UN, we must work with our international partners to ensure global action. At present around 7% of deaths are due to infections. If we do not act, this could rise to 40% – as it was before we had antibiotics.”

Dr Jeremy Farrar, Director of the Wellcome Trust and Longitude Committee, said: “Over the past two years Jim O’Neill and his team have raised the global profile of drug-resistant infection to its rightful place as one of the most pressing economic and health security issues of our time. These recommendations offer a road map for stopping growing resistance to our best drugs from claiming millions of lives. It is now up to world leaders, business and civil society to respond to this vital call for action, and create the incentives for preserving existing drugs and developing new ones that we need to address this critical challenge.”

Professor Peter Piot, Director, London School of Hygiene and Tropical Medicine, Longitude Committee, Longitude Prize Advisory Panel Co-chair, said: “We welcome this final Report of the AMR Review, and are pleased to see rapid diagnostics as one of the priorities. We hope the Longitude Prize will help to speed up existing and novel work on developing these. The winning diagnostic would require the wide-ranging support the Report calls for, to ensure effective tests are part of the decision making process for antibiotics, and have a real opportunity to improve health outcomes for future generations.”