The Review on Antimicrobial Resistance was commissioned in July 2014 by the U.K. government to analyse the global problem of antimicrobial resistance and to propose concrete steps to deal with it. A remarkably enlightened move, I may add, given that U.K is not actually one of the countries with high rates of antimicrobial resistance, and probably in large part driven by Dame Sally Davies – chief medical officer of England – who recognised the problem early and has actively championed efforts against the problem. It is chaired by Lord Jim O’ Neill, an economist who is the current Commercial Secretary of the Treasury and prior Chairman of Goldman Sachs Asset Management. The members of the advisory group are an international group of prominent economists, business and health professionals. The final report of the Review was published a couple of days ago and is available here.
The recommendations are split into efforts to reduce demand on antibiotics:
- Global public awareness campaign on antimicrobial resistance.
- Improving hygiene and sanitation, including access to clean water in less developed countries.
- Reducing the unnecessary use of antibiotics in agriculture, and preventing antibiotics from reaching the environment either from sewage and agricultural use, or from the manufacture of the drugs.
- Improving the global surveillance of antimicrobial resistance and antibiotic consumption.
- Promoting new rapid diagnostics to cut down inappropriate antibiotic use.
- Promoting the use of vaccines and alternatives in both humans and animals.
- Improving the numbers, pay and recognition of people working in infectious diseases (certainly a very welcome and highly popular recommendation among ID physicians and microbiologists!).
And efforts to increase the number of new and effective antibiotics:
- To establish a global innovation fund for early and non-commercial research into new antibiotics.
- Better incentives to promote development of new drugs and to improve existing ones.
And finally, to build a global coalition for action on antimicrobial resistance. The Review also described how all the above could be paid for, especially taking into account the current and future ruinous costs of antimicrobial resistance.