This Month has saw the publication of the Final Report from the Review on Antimicrobial Resistance, Tackling Drug-Resistant Infections Globally. The publication follows 19 months of consultation and eight interim papers, each focusing on a specific aspect of antimicrobial resistance (AMR).  The Final report sets out the Review on Antimicrobial Resistance’s final recommendations to tackle AMR in a global way.

The rise of antimicrobial resistance now recognised as a global crisis, one of the greatest threats to health today.  Antimicrobial resistance is on the rise in every region of the world with first-line antibiotics effectiveness being lost. This makes a broad range of common infections much more difficult to treat.  Second and third-choice antibiotics are costlier, more toxic, need much longer durations of treatment, and may require administration in intensive care units.

It is estimated that by 2050, 10 million lives a year and a cumulative 100 trillion USD of economic output are at risk due to the rise of drug resistant infections if proactive solutions are not found now to slow down the rise of drug resistance. Even today, 700,000 people die of resistant infections every year. Most of the direct and much of the indirect impact of AMR will fall on low and middle‑income countries.

The report details 10 areas for immediate action:

1. A massive global public awareness campaign
2. Improve hygiene and prevent the spread of infection
3. Reduce unnecessary use of antimicrobials in agriculture and their dissemination into the environment
4. Improve global surveillance of drug resistance and antimicrobial consumption in humans and animals
5. Promote new, rapid diagnostics to cut unnecessary use of antibiotics
6. Promote development and use of vaccines and alternatives
7. Improve the numbers, pay and recognition of people working in infectious disease
8. Establish a Global Innovation Fund for early-stage and non-commercial research
9. Better incentives to promote investment for new drugs and improving existing ones
10. Build a global coalition for real action – via the G20 and the UN

It is becoming increasingly important, particularly in Africa where microbiological laboratory support is scant, that antimicrobials are used judiciously. There is little antimicrobial susceptibility surveillance and therefore the extent of resistance in most of the African countries, bar a few like South Africa, Kenya and Egypt is not well described in the published literature.

ICAN is collaborating with the British Society of Antimicrobial Chemotherapy to conduct surveys in Africa towards assessing infra-structure, laboratory support and antimicrobial stewardship programmes on the continent. The ultimate goal is to seriously consider well trained IPC practitioners who are usually nurses, to become more involved in antimicrobial prescription; this is currently happening with anti-TB therapy and HAART in many African countries especially in the rural settings.  ICAN promotes a strategy where nurses are equal partners as champions of antimicrobial stewardship and guardians of antimicrobial agents by ensuring appropriate prescription of these invaluable life-saving drugs. All of us have consider containing the spread of multiple antimicrobial resistant bacteria by appropriate prescription and strong infection control programmes as a priority. 

For more information, visit the Review website here 

The World Health Organization factsheet on Antimicrobial Resistance can be found here