Antibiotics resistance should be a global grand challenge

The threat posed by the spread of antibiotic-resistant strains of bacteria is not news to many – but the message bears repeating.  Resistance is shooting up across the globe with an increasing number of infections defying treatment with antibiotics.

The finger of blame points to heavy over-prescription by doctors around the world, the broad use of antibiotics in livestock, and poor infection control in hospitals.

Heightened awareness among the public, clinicians, policymakers and farmers is crucial to reverse, or at the very least stall, the steady march of drug resistance, says Laura Piddock, a microbiologist at Birmingham University and former president of the British Society for Antimicrobial Chemotherapy (BSAC).

“As absence of new antibiotics affects everyone: shifting this issue out of the medical arena and into the public eye is paramount,” she told Science|Business.

On her initiative, Antibiotic Action, a UK charity campaign launched by BSAC, is sounding the alarm and trying to raise the profile of new antibiotics research. 

But are policymakers meeting the challenge? “Of course not,” replies Piddock firmly. “There needs to be antibiotic resistance initiatives in every single country – the issue needs to be recognised as a grand challenge.”

Piddock’s comments follow the recent stark warning by the World Health Organisation (WHO), which concluded in a new report that common bacteria are becoming resistant to antibiotics in “every region of the world.”

Far from being an “apocalyptic fantasy”, the stakes are so high that the WHO warns there will be deaths from minor surgery within 20 years if new antibiotics are not discovered.

As things stand, the EU says antibiotic resistance contributes to 25,000 deaths each year, and costs over €1.5 billion in healthcare expenses and lost productivity.

Instead of plodding political will, the matter needs to be viewed in much the same way as AIDs and HIV were in the 1990s, says Piddock. “We need to treat it with the same kind of urgency – too often it’s been viewed as some other country’s problem.”

Drastic actions

No new class of antibiotics has been discovered and brought to market since 1987. As a result, we are now at a tipping point, Piddock says.  Urgent work is needed to re-stock antibiotic armouries.

“The European Union’s efforts have been good and commendable,” she says. “The EU-funded innovative medicines initiative has a good premise: linking researchers and companies. There are criticisms of it but it’s worth letting it work its way through the timetable it’s been given.”

The EU, which launched a five year plan in 2011, has put a figure of €800 million on its own efforts to fight antibiotic resistance.

However, it’s debatable how much progress has been made in bringing the issue to the forefront of people’s minds, to try and encourage more responsible use of antibiotics and to improve infection control.

In 2009, in a bid to cajole public awareness, the EU announced the annual European Antimicrobial Awareness Day, with the message, “everyone’s responsible.”

But today there’s only a modest increase in recognition from Europeans about the threat of overusing these medicines, says Piddock.

For example, in 2013 only 40 per cent of people were aware that antibiotics do not kill viruses, a gain of just four per cent on 2009 figures, according to a Eurobarometer survey.

Outside the EU sphere, Piddock is impressed by the European joint programming initiative on antimicrobial resistance, which is another very useful action,” she says.

Searching for inspiration  

Among the grim reports, are there signs of promise anywhere? “The fact that more and more people are talking about this is good, they weren’t two years ago,” said Piddock. “I have been speaking at meetings I would not normally be invited to; antibiotics are getting onto the agendas of all sorts of meetings they would not have done normally.”

The G8 discussed it last year, as did the Davos gathering. The WHO is dedicated to it now too, she adds.

For Piddock, the hero of the cause is Sally Davies, the UK’s chief medical officer. “She was among the first to publicise it and the media followed on from there,” she says. 

Last year, Davies recommended that antibiotic resistance be added to the UK government’s list of threats to national security, alongside pandemic influenza and terrorism.

Piddock is happy to see the issue given such priority and warns that other governments need to follow suit.

To read more about Antibiotic Action’s “arms race”, visit here.