Expanding the antimicrobial toolkit

Antimicrobial resistance, or AMR, is one of the World Health Organization’s top ten threats to global health. AMR currently causes 700,000 deaths globally every year, rising to 10 million yearly deaths by 2050 in a worst-case scenario.

Earlier this year, the Academy and the Royal Society jointly hosted a symposium about new strategies and tools to combat AMR – read on for some of the key conclusions and download the full meeting report from the side of this page.

New drugs

“Antibiotics are like fire extinguishers – they must treat the problem rapidly and, importantly, must be available before disaster strikes.” Dr John Rex, Chief Medical Officer, F2G

We must have effective antibiotics to treat disease outbreaks ahead of when we need them. But constant use of the same drugs mean bacteria and other infectious microorganisms are evolving resistance more quickly. With the most recent completely new class of antibiotics discovered in the 1980s, scientists are putting huge effort into broadening our antibiotic toolkit. For example, Dr Heather Fairhead of Phico Therapeutics explained how her team are using engineered bacterial viruses to hunt down and destroy bacteria.

Not just new drugs

But we can’t rely solely on creating new antibiotics. Professor Alison Holmes FMedSci explained AMR funding is heavily skewed towards drug development rather than areas such as policy, education, and systems for monitoring antibiotic usage and resistance, which could have equal if not greater value.   

Use with care

For example, a third of all antibiotics used in England and Wales are prescribed inappropriately. Dr Tina Joshi highlighted how rapid diagnostic tests that quickly differentiate between viral or bacterial infections could reduce this unnecessary antibiotic use.

The Netflix model

Antibiotics should be used briefly and sparingly, which by definition makes them less profitable. As a result many large pharmaceutical companies have slowed or even stopped their antibiotic research.

Dr Colm Leonard and David Glover described a new pilot scheme where the National Institute for Health and Care Excellence, which sources cost-effective drugs for the NHS, pays pharmaceutical companies £10 million per year for every NHS antibiotic drug. This Netflix-style subscription model shifts away from the cost per use to offer steady cashflow for future antibiotic development.

Speak up

Many proposed solutions to the challenges of AMR involve behaviour change. The AMR community must learn from how other scientists have communicated during the COVID-19 pandemic, which has shown people can and will change their behaviour when provided with relevant information and clear actions.

Global problems require global solutions

“The challenges surrounding AMR are every bit as complex as those associated with climate change.” – Professor Dame Sally Davies FMedSci, UK Special Envoy on Antimicrobial Resistance.

As with the current climate crisis, we need a collective, worldwide effort to combat AMR effectively. Dame Sally noted how the UK’s Netflix-style subscription model is being echoed by policies in the USA and Sweden. The global collective AMR Action Fund, supported by GSK, the European Investment Bank and Pfizer, aims to invest over $1 billion in developing new antibiotics and bring 2-4 novel antibiotic therapies to market by 2030.

The situation is now being taken more seriously, with the world collaborating on many fronts to solve the multi-faceted challenges of AMR. By cooperating today, we can save lives tomorrow.

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