By Robin Grimes.
This year the UK is committed to take action on antimicrobial resistance (AMR) – a global challenge requiring a global response. No country or region can insulate itself from drug resistant infections. Tackling antimicrobial resistance is high on the UK agenda and we believe 2016 can be a breakthrough year for international efforts. Hong Kong has also recognised the scale of the challenge. Chief Executive CY Leung, in his most recent Policy Address, announced plans to establish a high level steering committee to formulate strategies to tackle the threat of AMR.
Halting the spread of AMR is one of the major global health challenges of the early 21st century. It is estimated that around 700,000 people die each year from drug resistant diseases (including drug resistant strains of HIV, TB and malaria). If not tackled, AMR could cause up to 10 million deaths annually by 2050, with a cumulative cost to the world of up to US$100 trillion in lost economic output.
The UK government considers the threat of antimicrobial resistance as seriously as it does a terrorist attack, a flu pandemic or major flooding. We have made considerable progress including better data, guidance, a strengthened framework for antimicrobial stewardship and established unprecedented levels of research collaboration together with increased investment. The result is one of the most comprehensive surveillance systems in the world.
Last year we published a Code of Practice on the prevention and control of infection and related guidance. We have published a range of material to support best practice on antibiotic stewardship and infection prevention and control, including antibiotic prescribing quality measures. To support this we have introduced incentives for the National Health Service to improve prescribing of antibiotics and the quality of data collection. We are amalgamating existing data on infections and prescribing, and making it readily accessible, including to the public. This will allow local teams to benchmark their data against the national picture and data from other comparable organisations.
AMR is a consequence of the overuse of antimicrobials both in humans, and in animals (where they are often used as growth promoters). The classes of antibiotics used for humans and for food producing animals are generally the same, thereby increasing the risk of the emergence and spread of resistant bacteria. Efforts on antimicrobial resistance must therefore be part of wider action to strengthen health systems, including infection prevention and control. Hong Kong has a wealth of expertise from which the UK can benefit.
The UK has strengthened guidance to vets and animal keepers to reflect the government position that routine preventative use of antibiotics is not acceptable. We have been working closely with vets and agriculture professionals to promote the importance of responsible use, and with the livestock industry, to develop systems for collecting more accurate data on the use of antibiotics in pigs, poultry and cattle, which have been identified as priority species groups.
In the UK we have recognised that an effective response will require global action, using a “One Health” and multi-sector approach encompassing health, agriculture, development, research, finance and economic ministries. Only a concerted effort by government and industry can tackle simultaneously the economic, human and animal health challenges involved.
The AMR threat is exacerbated by current failings in the market to produce new treatments and diagnostics to combat resistance diseases. Current research suggests that addressing market failures that prevent the development of new antimicrobials, and making their development commercially viable, are key to maintaining momentum towards global action.
In 2014 UK Prime Minister David Cameron appointed Lord O’Neill to conduct a Review to analyse the global problem of AMR and propose concrete actions to tackle it internationally. The independent Review is engaging widely with international stakeholders to understand and propose solutions to the problem of AMR from an economic and social perspective and its final report is due to be published in May. The UK is also committed to mobilising political support for AMR through the G7, G20 and later in the year at the UN General Assembly.
To achieve these ambitious goals the UK is focused on mobilising the international community in support of a multilateral approach to the AMR challenge. The UK and Hong Kong are already committed to working together on AMR, and a number of other health care challenges, through the signing of a Memorandum of Understanding on health cooperation at the end of last year. We look forward to continuing to develop our collaboration with Hong Kong on the shared global challenge of AMR.
Robin Grimes is currently Professor of Materials Physics at Imperial College. His research is focussed on the use of high performance computing techniques to understand the behaviour of materials for energy applications including nuclear fission and fusion, fuel cells, batteries and solar cells. He is also Principal Investigator of the Research Council’s UK Nuclear Fission consortium project.
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