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The first World Health Organization (WHO) report to look at the global picture of antimicrobial resistance reports that surveillance has shown resistance present in every region of the world and specifically that antibiotic resistance is now a major threat to public health.
Dr Jeremy Farrar, Director of the Wellcome Trust, said:
“We welcome the WHO report which highlights AMR as a pressing global issue. However, we believe there is too much focus on more surveillance and this is a missed opportunity. While surveillance is important and certainly needs to be improved it does not solve the problem. Committed and coordinated action is required across international governments and stakeholders to address the critical gaps in challenging the AMR threat.
“This is a complex issue and requires a multifaceted approach addressing fundamental and translational research to understand the emergence and spread of resistant pathogens. The problem demands improved use of existing interventions, accelerated therapeutic development, economic incentives and simplified regulatory approval processes to support the development of point of care diagnostics and drug discovery. A better understanding of the impact of prescribing and health behaviours is also crucial.
“There has been much discussion on this issue, what is required now is concerted action.”
Professor Nigel Brown, President of the Society for General Microbiology:
“We welcome this WHO report, which highlights the growing levels of antimicrobial resistance, an issue that is of national and international concern.
“While the report is right to raise the importance of good surveillance data if we are to understand the extent of antimicrobial resistance, more data are not the total solution to the problem, which will ultimately come from scientific research.
“It is vital that microbiologists and other researchers work together to develop new approaches to tackle antimicrobial resistance. These approaches will include new antibiotics, but should also include studies to develop new rapid-diagnostic devices, fundamental research to understand how microbes become resistant to drugs, and how human behaviour influences the spread of resistance.”
Prof Martin Adams, President of the Society for Applied Microbiology (SfAM), said:
“SfAM welcomes the WHO report on antimicrobial resistance. As the report’s authors acknowledge, the fact that many countries were unable to provide data on all of the microbe-antimicrobial combinations in question is worrying. That said, whilst surveillance is clearly important – we cannot know the extent or location of the problem, or, indeed, the contribution of international travel and trade to the spread of resistance without it – this must not be seen as a solution.
“At the same time as improving surveillance, there must also be a global effort on prevention and control of infections involving drug resistant microbes in humans and animals. This will require development and implementation of new products, policies, and practices; and fundamental research to unpick the mechanisms by which resistance develops and can be passed between microorganisms and from environment to environment. Even if there are new antimicrobial drugs brought to market, we will still face the spectre of resistance unless we can learn how to minimise or slow its development.
“Ideally, as well as surveillance of infection, there would be considerable support for research into the distribution and evolution of the genes that confer resistance. We still know very little about the transfer of resistance genes between the harmless organisms that live on and in us and those microbes that can cause disease. We could also learn more about the geographical spread of resistance by following the unique genetic characteristics of resistant organisms.
“In addition, we must better understand the role of animal rearing in the development and spread of resistance, globally, both in terms of antibiotic use in an agricultural/veterinary context and also as a source of foodborne disease. There has been much talk of the misuse of antibiotics in agriculture as a major source of antimicrobial resistance, but in reality, it is difficult to draw such a conclusion from current data.”
Dr Nicholas Brown, President of British Society for Antimicrobial Chemotherapy (BSAC), and Consultant Microbiologist, Addenbrooke’s Hospital Cambridge said:
“BSAC commends the WHO report. We hope that the global work programme under development will provide the framework through which governments worldwide will take responsibility and make funding available to initiate steps to protect the few antibiotics we have that remain effective against resistant bacteria. We also hope that this framework will be the mechanism by which appropriate use of antibiotics across all sectors, people and animals, can be achieved.”
Professor Laura Piddock, BSAC Chair in Public Engagement, Director of Antibiotic Action and Professor of Microbiology, University of Birmingham said:
“This report aptly demonstrates why initiatives such as Antibiotic Action (www.antibiotic- action.com) are so important. It adds to a long list of reports published by many in the last ten years about this crisis, what is now needed is action – hopefully this report will provide the impetus. The world needs to respond as it did to the AIDs crisis of the 1980s. To do this, we need to be ambitious to succeed – moves such as a fully funded mandatory global surveillance programme will document the size of the problem and funded public education will help minimise use – but these are just starting points. We still need a better understanding of all aspects of resistance as well as new discovery, research and development of new antibiotics.
“Defeating drug resistance will require political will, commitment from all stakeholders, and considerable financial investment in research, surveillance and stewardship programmes. For many years there has been a reliance on work funded by learned societies and other charities – such as the BSAC resistance surveillance programme (www.resurv.org) which is now in its 15th year – to provide data by which to map antimicrobial resistance and emerging resistance. Such programmes are invaluable but they are also expensive to maintain and, to have global impact, need to be funded from the ‘public purse’ so that their successes and value can be replicated to make the global difference that is needed. As funding from UK government agencies for research on antibiotics has continually dwindled (last year it was only 0.7% of available UK research funding) there needs to be a significant increase in national and global funding to be able to address this public health crisis.”
Declared interests
None declared