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21st March 2020
AMR – progress on the UK strategy and coordinating a global response.

Antimicrobial resistance – progress on the UK strategy and coordinating a global response 20 February 2020.

Twelve months since the launch of the UK 5 year action plan for antimicrobial resistance, and it was a full house of colleagues working in AMR which gathered at the Westminster Forum overlooking London Bridge and the Thames.

The short, but punchy, agenda included health economics perspectives, the role of vaccines in tackling AMR, and improving diagnostics and patient experience. All topics close to the heart of the Bloomsbury SET.

The role of pharmaceutical companies, and the lack of incentivisation for new antimicrobials was a message echoed throughout the morning. Similarly when choosing a diagnostic, the speaker from Becton Dickinson noted their own globally available S5 test, which often isn’t chosen as a typical antibiotic costs mere cents.

The discussion included the roles of “prescribers” in the antimicrobial chain, but also the experience and understanding of the patients. Rose Gallagher from the Royal College of Nursing explained the real human cost of resistant infections, and the work they are undertaking in policy and practice development working with colleagues in arts led organisations (the RIPEN project) to co-develop a policy agenda for action.

It was also heartening to see the great process on reducing prescriptions in the UK, by all sectors but most notably the farming community. This self-driven change was not the result of government mandate, but through the actions of the sector, resulting in a real change of a 53% reduction of use in the veterinary market since 2014.

The role of public engagement and the “power of the crowd” was a welcome addition from Dr Roger Harrison at the University of Manchester, noting the success of simple initiatives in schools like the value of washing your hands in preventing infection!

Challenges around alternatives to anti-microbial, such as diagnostics and vaccines were explored including talks from colleagues at NIBSC.

For me, the most valuable presentation came from a Consultant Microbiologist, working in a Nottinghamshire hospital, who not only shared the best slides, but more importantly highlighted the value of making the best usage of tools already at our disposal, in addition to exploring new solutions.  Working in hospitals, Dr Weinbren described how simple changes in protocol in for blood cultures can support infection control and treatment.

The morning closed by Dame Sally Davis, now firmly embedded in her role as UK Special Envoy on AMR for UK Government, discussing where we are in the UK now, and what the global challenges will be. If, as a community, we are truly inclusive of the One Health approach, Dame Sally discussed the role of the environment in infection and AMR. This comes in many forms, including factories producing medicines not being rigorous in commercial waste management, excretion of AMR from animal waste, in addition to cross infections cause by poor clinical waste handling (illustrated earlier in the day by a truly gruesome story from Dr Weinbren related to the environmental original of a hospital acquired infection!)

The funding available, and the outputs of existing projects are somewhat mixed. Dame Sally noted concern that UKRI has not really embraced the funding required to tackle this challenge, despite its inclusion on the UK risk register, alongside terrorism, as a major threat. Funding for bringing data and monitoring together, is not yet really visible, but projects from CARB-X and the Fleming Fund are showing promise. However, five years into the Longitude Prize there is no light at the end of the tunnel. Whilst there was great debate, with some progress to be celebrated, Dame Sally closed the day noting that “You all contribute to this, [so] please go on! We need more, but we’ve come a long way.”

The Bloomsbury SET endeavours to produce new knowledge exchange outputs and impact related to infectious disease and AMR, including supporting new vaccines, big data analysis, and diagnostics, but this is no easy feat for the global community concerned in tackling this 21st century challenge.

The day this event blog was written (21 February 2020) a new antibiotic was hailed, published in the journal Cell, and hidden away in the Science section of the Guardian website. Discovered through an AI programme using Drug Repurposing Hub, this research demonstrates potential new antibiotics which could be used to treat those most challenging resistant infections. It’s a new discovery today, but where will we be in another 12 months in the battle against AMR?

Dr Emma Tomlinson, Head of Research Development, RVC
Chair of the Bloomsbury SET Steering Group

 

Find out more:

Cell article: Deep Learning Approach to Antibiotic Discovery https://www.cell.com/cell/fulltext/S0092-8674(20)30102-1?utm_medium=homepage

Guardian article: https://www.theguardian.com/society/2020/feb/20/antibiotic-that-kills-drug-resistant-bacteria-discovered-through-ai

Antibiotics in agriculture: https://www.nfuonline.com/sectors/animal-health/animal-health-news/blog-the-use-of-antibiotics-in-agriculture/

Association of the British Pharmaceutical Industry https://www.abpi.org.uk/new-medicines/antimicrobial-resistance-amr/

The AMR Industry Alliance https://www.amrindustryalliance.org/wp-content/uploads/2020/01/AMR-2020-Progress-Report.pdf

CARB-X: https://carb-x.org/

Fleming Fund: https://www.flemingfund.org/

The Longitude Prize https://longitudeprize.org/

 

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