The British government has published a 20-year vision and 5-year national action plan for how the UK will contribute to containing and controlling antimicrobial resistance (AMR) by 2040.
The plans include targets, such as cutting the number of drug-resistant infections by 10% (5,000 infections) by 2025, reducing the use of antibiotics in humans by 15%, and preventing at least 15,000 patients from contracting infections as a result of their healthcare each year by 2024.
A major focus of the plan is to make sure current antibiotics stay effective by reducing the number of resistant infections and supporting clinicians to prescribe appropriately.
New technology will also be used to gather real-time patient data, helping clinicians understand when to use and preserve antibiotics in their treatment. This could be followed and adapted all over the world, building the database on antibiotic use and resistance.
The plans cover animals and the environment as well as human health. The government has committed to working with vets and farmers to further reduce antibiotic use in animals by 25% between 2016 and 2020, with objectives to be refreshed by 2021.
The pharmaceutical industry will also be expected to take more responsibility for antibiotic resistance. The National Health Service (NHS) will explore a new payment model that pays pharmaceutical companies based on how valuable their medicines are to the NHS, rather than on the quantity of antibiotics sold.
Historically, pharmaceutical companies have been reluctant to invest heavily in developing new antibiotics as other medicines are more lucrative.
Antibiotic resistance is predicted to kill 10 million people every year by 2050 without action. Without effective antibiotics, straightforward, everyday operations like caesarean sections or hip replacements could become too dangerous to perform.
Since 2014, the UK has cut the amount of antibiotics it uses by more than 7% and sales of antibiotics for use in food-producing animals have dropped by 40%. But the number of drug-resistant bloodstream infections have increased by 35% from 2013 to 2017.
Prime Minister Theresa May said the increase in antibiotic resistance is a threat we cannot afford to ignore, and that the UK will continue to work with its partners to drive international action that will protect the health of future generations.
The World Health Organization says all countries need national action plans on AMR and that single, isolated interventions have limited impact. Instead, coordinated action is required to minimize the emergence and spread of antimicrobial resistance within the country and across the world.
WHO also calls for greater innovation and investment in research and development of new antimicrobial medicines, vaccines, and diagnostic tools.
105 countries have a surveillance system in place for reporting drug-resistant infections in human health and 68 countries have a system for tracking consumption of antimicrobials. In addition, 123 countries have policies to regulate the sale of antimicrobials, including the requirement of a prescription for human use.
But implementation of these policies varies and unregulated medicines are still available in places such as street markets, with no limits on how they are used. Medicines are very often sold over the counter and no prescription is requested. This puts human and animal health at risk, potentially contributing to the development of antimicrobial resistance.
There is much room for improvement, particularly in animal and food sectors, where there is an urgent need for more investment and action. According to WHO, a total of 67 countries report at least having legislation in place to control all aspects of production, licensing and distribution of antimicrobials for use in animals. But 56 either have no national policy or legislation regarding the quality, safety and efficacy of antimicrobial products used in animal and plant health, and their distribution, sale or use.