Felicity Harvey, Director General for Public
Health, talks about implementing the UK AMR Strategy and continued
prioritisation and support.
Antimicrobial resistance (AMR), especially resistance to
antibiotics, is a growing problem and there is now a risk that the practice of
modern medicine will not be possible in the next 20 years because we have run
out of effective antibiotics. I, like Dame Sally Davies, our Chief Medical
Officer (CMO), am determined that will not happen, not just for us, but for
future generations.
In
September 2013, we published the UK Five Year AMR Strategy with the
goal of slowing the growth of AMR by taking an integrated approach
across human and animal health and the environment at both national and
international levels. An early priority has been to agree a set of measures
against which we could track progress towards our goal.
The
Advisory Committee on Antimicrobial Resistance and Healthcare Associated
Infections (ARHAI) and Public Health England (PHE) have worked with us
to develop measures which
include resistance trends in selected drug-bug combinations and improvements in
the quality of prescribing in primary and secondary
care.
In
November we will publish our first annual progress report and a detailed
implementation plan with a focus on deliverables. The annual report will
describe progress across the areas that we have identified as the priorities
for action in this first phase. These are better data and information,
behaviour change, improved diagnostics and new treatments, enhanced research
and analysis and stronger international collaboration. We, and our partners,
are making good progress in each of these areas.
Progress DH has made
We
have undertaken a range of analyses and modelling of the burden and potential
impact of AMR on health, the NHS and the consequent economic and
social costs to inform the wider programme and help assess the likely
effectiveness of potential interventions to reduce AMR. We will be
publishing these later this year.
To
improve diagnostics we are working with experts including the Chief Scientific
Officer at NHSE, Medical Microbiology experts in PHE and academia,
National Institute for Health Research (NIHR) and the Medical Research Council
(MRC) to establish what is needed on the ground, where there are gaps and how
we can make sure that the right tests are available in the right settings
across the health system.
Research is crucial to our understanding of the
molecular basis of the emergence of spread of AMR, the significance of
transmission pathways between the environment, humans, animals and the food
supply chain in promoting the transfer of resistance in human and veterinary
pathogens to help target our interventions. We also need research to help
develop new drugs, alternative therapies and improved diagnostic
technologies.
In
April, two NIHR Health Protection Research Units, focusing on Health
Care Associated Infections and AMR were established,
between PHE and academic partners. A new AMR Research
Funder’s Forum, led by the MRChas been set up to
co-ordinate AMR related research and promote joint action to better
understand the relationship between AMR in humans and
animals.
The
UK has been at the forefront of action internationally working with other
governments and global organisations including the World Health Organization
(WHO) and the World Organisation for Animal Health (OIE), to drive forward
coordinated action at an international level.
I
am enormously proud of our achievements on the international stage. Together
with Sweden, we have led the development and adoption of a new WHO resolution
on AMR. The Resolution provides a mandate for development of a WHO led
global action plan by May 2015. We will have a key role in influencing and
contributing to the development of the action plan and continuing to support
the global movement to tackle AMR.
Progress our partners have made
To
provide better data and information, PHE has been working with a wide
range of bodies to strengthen our national surveillance programme, improving
our ability to monitor trends in resistance and integrate data on how
antibiotics are used in hospitals, GP surgeries and other healthcare settings.
In September, it will publish its first annual report providing a baseline from
which to monitor future trends and assess the impact of our
interventions.
PHE is stepping up its work with partners across
the human health and social care system, holding a workshop with experts in the
summer to develop an integrated plan to deliver system wide change. NHS
England, NICE and Health Education England are all supporting work to
change behaviours and improve the quality of antibiotic
prescribing.
The
Veterinary Medicines Directorate of Defra and the Responsible Use of Medicines
in Agriculture Alliance (RUMA) are undertaking comprehensive sector engagement
activities to consider the issues and share good practice.
Much more to be done
However, I am not complacent and while I recognise the
significant achievements on the international front, there is much more that
needs to be done to deliver real change nationally to improve our infection
prevention and control, better control the use of antibiotics and to support
the development of new classes of antibiotics, diagnostics and new
treatments.
We
already have good support from the Royal Colleges and the Faculty of Public
Health. This, together with RUMA’s strategy and action plan, issued
in April this year, demonstrate that we in the UK are of one voice and truly
working together to tackle this important issue.
We
can only achieve the goal of the strategy if we continue to work together in
this way. The progress report and action plan we publish in the autumn, will
provide more detail about what we have and what we intend to achieve together.
I call on you now, professionals, health care workers, academics and industry
to keep the fight against AMR as a priority in your organisations and
to continue to work with us to make those changes that need to happen to
deliver our goal.