The U.K. Parliament’s Science and Technology Committee has set up a review of antimicrobials.
The terms of reference of the committee are:
“Antimicrobial resistance is widely considered to pose one of
the greatest risks to modern medicine faced by this generation. Without
effective antimicrobials, chemotherapy for cancer and invasive operations would
become increasingly dangerous due to the likelihood of infection. The
Government appears to recognise this threat to society and we were pleased to
see the production of its Five Year Antimicrobial Resistance Strategy. It is
clear to us that there is no room for procrastination and, in this report, we
urge the Government to take immediate and decisive action. Two weapons in our
arsenal against antimicrobial resistance were repeatedly underlined to us:
improved stewardship to extend the effective life of existing antimicrobials
and increased innovation to develop new treatments.
For too long, antibiotics have been used as if they were a
bottomless pit of cure-all miracle treatments. Antibiotics are ineffective
against viruses and other diseases that are not caused by bacteria and the
unnecessary prescription of antibiotics has contributed to the acceleration of
antibiotic resistance. It is vital that the Government takes action to ensure
that antibiotic prescribing is founded on good diagnoses. To achieve this, there
is a need to develop cheap, rapid and accurate diagnostic tests and provide
better clinical training. Furthermore, whilst prescribers must be the stewards
of antimicrobials, the Government needs to ensure that clinicians are supported
through rigorous public awareness campaigns.
Whilst efforts to protect existing antibiotics must remain a
priority, policy must be evidence-based. There is a lack of data on the
post-prescription behaviour of patients and we suggest that the Government
develops a system for monitoring this. Furthermore, there is a lack of
information and evidence on the link between resistance in animal pathogens,
the environment, and resistance in human pathogens. The Government cannot rely
on the notion that curiosity-driven research will provide the information it
needs and must plan to fund the necessary research, directly.
As the list of resistant pathogens grows longer, it is clear
that fresh new treatments are required. We were dismayed to find that, since
the year 2000, just 5 new classes of antibiotics have been discovered and most
of these are ineffective against the increasingly significant problem posed by
gram negative bacteria. The ability for companies to re-coup the costs of their
investments into antibiotics has become hampered by a global market that fails
to provide financial incentives. Of the 18 to 20 pharmaceutical companies, who
were the main suppliers of new antibiotics 20 years ago, just a handful of
companies persist in this field. We urge the Government to undertake immediate
scoping of pricing alternatives, and to demonstrate to us how they plan to
incentivise organisations to invest in new antimicrobials on a global basis.
The life sciences sector must be encouraged to re-engage in this field before
the pipeline of antibiotics runs dry. In that respect we welcome and support
the Prime Minister's commitment to review the economic issues surrounding
antimicrobial resistance.”
Posted by Tim Sandle
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