Antibiotic-resistant bacteria like staphylococcus aureus could take us back to the 19th Century. © Janice Haney Carr
The soaring number of antibiotic-resistant infections we are now seeing poses such a great threat to society that in 20 years' time we could be taken back to a 19th-century environment where everyday infections kill. In Europe alone, 25,000 people a year already die from infections that are resistant to our drugs of last resort. We have reached a critical point and must act now on a global scale to slow the situation down.
Antimicrobial resistance (AMR) has developed over the years through incorrect and over-use of antibiotics. They have been used to treat viruses—against which they are ineffective—simply because a doctor does not have the means to identify the source of an infection. Patients do not always complete the full course of antibiotics prescribed. They are also used in animal feed to promote growth. Incorrectly using antibiotics in all these ways means that bacteria are able to develop resistance.
AMR is a global problem. My annual report last year, with contributions from more than 50 experts, drew national and global attention to the problem of AMR. As a result, it was placed on the risk registers of both the Department of Health and the Department for Environment, Food and Rural Affairs. The new UK cross-government strategy was subsequently strengthened to include an action plan. But no country can resolve the issues of AMR alone—this needs global cooperation and mutual support.
Momentum is developing. The World Health Organisation recently released a report on antimicrobial resistance, confirming that it now regards AMR as a major threat to public health, allowing it to lead a global, coordinated effort to tackle this problem. We must build on this impetus by developing a test that can determine the crucial issue: whether the patient needs an antibiotic at all. This is the first step in conserving antibiotics by ensuring that they are only prescribed for bacterial infections, enabling us to slow the development of resistance.
If a patient is unwell and has a temperature, it is typically an infection. If it is a virus, the antibiotics will not work; while in Africa, where it could be malaria, this could be missed. General practice is a good example of doctors making clinical decisions in the prescribing of antibiotics, educated by their experience. But this does not mean that they are always right.
How can we focus research efforts on this problem? The Longitude Prize, launched last week, offers the public the opportunity to vote for what they believe is the biggest scientific challenge facing the world at the moment. Those who manage to develop a solution to that problem will win a £10m prize, provided by the government-funded Technology Strategy Board and innovation charity Nesta. That means that if AMR is selected as the greatest challenge, some of the UK’s brightest minds will focus on the development of a diagnostic tool that can confirm a bacterial infection.
The fight against AMR is about innovation as well as invention; we need to put together existing technologies to come up with a solution. This innovation will come from universities and researchers, and as these models develop, pharmaceutical companies will no doubt watch with interest. I hope they, too, will be encouraged to drive forward much needed investment in this area. We need a diagnostic tool that could be used across the world, and this is the moment to act.
Cast your vote for the Longitude Prize here.
