Confronting Antimicrobial Resistance: current challenges and strategies

AMR is a significant global threat that undermines the effectiveness of antimicrobials against common infections.

In response to this growing crisis, the World Health Organization (WHO) launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015.

This system aims to monitor the extent and spread of AMR and inform strategies at all levels, integrating data from human surveillance, antimicrobial use, and food chain and environmental assessments. This standardized approach enables countries to collect, analyze, interpret, and share data effectively.

The 2022 GLASS report revealed concerning resistance rates among prevalent bacterial pathogens. Notably, 42 per cent of E. coli strains were resistant to third-generation cephalosporins, and 35 per cent of Staphylococcus aureus strains were methicillin-resistant.

Alarmingly, one in five urinary tract infections caused by E. coli showed reduced susceptibility to commonly prescribed antibiotics, such as ampicillin, co-trimoxazole, and fluoroquinolones. This trend emphasizes the growing difficulty in treating common infections effectively.

Global action plans to combat AMR

In recognition of the AMR crisis, the World Health Assembly adopted a Global Action Plan (GAP) in May 2015 with five key objectives:

Improve awareness: Enhance understanding of antimicrobial resistance through effective communication, education, and training.

Strengthen knowledge: Build a robust evidence base through surveillance and research.

Reduce infections: Implement effective sanitation, hygiene, and infection prevention measures.

Optimize use: Promote the responsible use of antimicrobial medicines in human and animal health.

Economic investment: Develop a sustainable economic case for investment in new medicines, diagnostic tools, vaccines, and interventions.

Building on this framework, the European member states published the AMR Roadmap 2023-2030, which aims to support countries in identifying, prioritizing, implementing, and monitoring high-impact interventions against AMR.

This roadmap emphasizes innovation, environmental and social determinants, and a focus on digital transformation and person-centered care. Its implementation is crucial for curbing AMR effectively.

Tripartite Joint Secretariat on AMR

To foster multi-stakeholder engagement, a Tripartite Joint Secretariat has been established, comprising the Food and Agriculture Organization (FAO), World Organization for Animal Health (OIE), and WHO.

This initiative aligns with the coordinated approach affirmed at the first UN High-Level Meeting on AMR in September 2016, which emphasized the integration of human, animal, plant, and environmental health sectors.

At the second UN General Assembly (UNGA) High-Level Meeting on AMR in September 2024 in New York City, key discussions focused on accelerating global multisectoral efforts to combat AMR. The WHO committed to supporting member states in developing and implementing National Action Plans.

The UK response to AMR

The UK National Action Plan (NAP) outlines actions to address the global threat of AMR, building on the country’s 20-year vision for AMR established in 2019.

The UK is committed to playing a leadership role in the global effort against AMR, especially as we navigate the post-COVID-19 era.

International collaboration and preparedness are critical, as no single nation can combat AMR alone. A coordinated, multilateral approach is essential for leveraging the UK’s expertise and experience.

Collaborative efforts across the UK

A coordinated effort among England, Scotland, Wales, and Northern Ireland is vital to achieve the NAP goals. Key reasons for this collaboration include:

• A shared vision to contain and control AMR.
• The borderless nature of pathogens.
• Similar challenges across the UK, offering opportunities for mutual learning.

Progress made in the UK

As one of the first countries to establish a NAP on AMR, the UK has made significant strides in raising awareness and directing resources effectively.

Since 2013, the UK has embraced the “One Health” approach to tackle AMR, which continues to be reinforced in the current NAP.

Recognizing the complexity of AMR, the UK is committed to a long-term strategy to strengthen understanding and control measures.

To facilitate this vision, the UK is developing a series of intermediate five-year NAPs. The first five-year plan (2019-2023) focused on a broad approach, enhancing health security both domestically and globally.

The new five-year NAP, titled “Confronting Antimicrobial Resistance 2024-2029,” builds on past achievements and lessons learned. It emphasizes protecting patients, the public, and the NHS, with nine strategic outcomes organized under four themes.

The plan encompasses 30 commitments [please refer to Figure 1] aimed at achieving outcomes across England, Scotland, Wales, and Northern Ireland. Key strategies include reducing the need for antimicrobials through infection prevention, optimizing antimicrobial use, encouraging investment in innovation, and fostering global partnerships.

By taking these comprehensive actions, the UK aims to effectively confront AMR and contribute to a sustainable global health future.

Additionally, these actions are intended to inspire other countries to intensify their efforts against AMR, ensuring the preservation and advancement of these vital medicines for future generations and addressing one of the most urgent global healthcare challenges we face today.

(Taken from: Confronting antimicrobial resistance 2024 to 2029 (publishing.service.gov.uk))

Dr. Sarah Hobson is Associate Manager of Regulatory Affairs at G&L.