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Antimicrobial Resistance: Why the next government needs to prepare for ‘the coming plague'

Could antimicrobial resistance (AMR) be the incoming government’s next major challenge? AMR is a growing global threat, responsible for one in eight global deaths a year – estimated to kill 50 million people per year by 2050. Could the next pandemic be on the horizon? DR LINDSEY EDWARDS says AMR and the development of new antibiotics, vaccines, and diagnostics needs urgent attention from the next government.

Could you die from a simple dental infection? Antimicrobial Resistance (AMR) means this could become an everyday reality.

Bacteria and other microbes are evolving to resist the drugs traditionally used to kill them, such as antibiotics, transforming treatable infections into potentially deadly threats. AMR is often dubbed the "silent coming plague," jeopardising our ability to treat patients safely, crippling healthcare systems, and complicating care delivery for the most vulnerable in society. This critical global health challenge threatens to undo decades of medical progress and endangers millions of lives annually. If not addressed, AMR will suck trillions of pounds from the global economy and put pressure on already struggling healthcare systems.

Data from the Global Research on Antimicrobial Resistance (GRAM) project reveals the staggering toll of common bacterial infections. 

Each year an estimated 7.7 million deaths globally are caused by bacterial infections — 1 in 8 of all global deaths, making bacterial infections the second largest cause of death globally. Out of these bacterial infection deaths, almost 5 million are associated with bacteria that have developed resistance to antibiotics. Alarmingly, 1.27 million are caused by bacterial pathogens resistant to all available antibiotics, this number is predicted to continue to rise. Young infants, the elderly, people with chronic illnesses (currently responsible for 41million global deaths per year) or those undergoing cancer treatments or requiring surgical procedures are at the highest risk.

Infections disproportionately affect low - and middle-income countries and AMR is inextricably linked with global warming and food security underscoring the urgent need for targeted interventions, and strengthened health systems, highlighting the utmost urgency of addressing this escalating global threat.

The World Health Organization (WHO) has highlighted the gravity of this crisis, noting that none of the 43 antibiotics currently in development adequately address this alarming global health crisis. This alarming situation underscores the urgent need for innovative and sustainable strategies to combat drug-resistant infections. The development of new antibiotics is crucial, however, it is not a long-term solution, as resistance to these drugs will eventually develop and any gains will be lost.

How gut microbiome plays a vital role in tackling AMR

Instead of just developing new antibiotics, which will in time become resistant, we can shift the focus on the gut microbiome, the community of microbes living in our digestive tracts, which play a vital role in maintaining our health. Diet and agricultural practices dramatically alter the microbiome and susceptibility to AMR.

Myself and colleagues at King’s are investigating modulation of the microbiome through “non-classical” therapies. Our research has found faecal microbiota transplantation (FMT) can help re-balance the microbiome to boost immunity, improve health and combat AMR. FMT involves the transplant of stool from a healthy donor to a patient, thereby introducing beneficial microbes that can out compete resistant bacteria. This approach reduces dependence on antibiotics and offers a novel method to fight infections.

Another innovative alternative is bacteriophage therapy, which uses viruses that specifically target and lyse pathogenic bacteria without harming beneficial microbes. The UK government has recognised the potential of bacteriophage therapy as another valuable alternative to antibiotics. Bacteriophages are currently used in the UK on compassionate grounds and are safe and effective. According to the Department of Innovation, Science and Technology, bacteriophage therapy represents a significant therapeutic potential and requires urgent development to tackle AMR effectively.

How the UK can lead the development of alternative therapies

Alternative treatments for AMR, such as FMT and bacteriophage therapy, require further research and funding into host-microbiome interactions. Understanding these interactions is essential for developing effective therapies and ensuring not only their safety and efficacy, but their longevity.

Addressing AMR comprehensively requires sustained commitment from the next government to foster collaboration across sectors and borders, mobilising global partnerships, and engaging diverse stakeholders. Dedicated funding opportunities and multidisciplinary approaches are needed to advance this research. Collaborative global efforts will be vital to uncovering the complexities of the microbiome and harnessing its potential to combat AMR.

The UK is well-positioned to lead the research and development of alternative therapies. With existing health system infrastructure, world-leading research organisations, and manufacturing capabilities, the UK has the potential to become a global leader in these innovative treatments. However, investment and funding are crucial to develop these capabilities further and ensure the UK capitalises on this opportunity to tackle AMR and become a major attraction for inward investment for a growth economy.

As the election approaches, it is imperative that any incoming government recognises the seriousness of AMR and continues to support initiatives aimed at combating this threat. Increased investment and support for research, infrastructure, and innovative therapies like FMT and bacteriophage therapy are essential. The next government must build on the UK's potential to deliver these exciting new treatments, ensuring that we are equipped to address the challenge of AMR and safeguard the health of future generations.

In this story

Lindsey  Edwards

Lindsey Edwards

Senior Lecturer in Microbiology

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