What is AMR?
The discovery and development of antibiotics was one of the greatest medical achievements of the 20th century. Since Sir Alexander Fleming discovered penicillin in 1928, antibiotics have been used to save the lives of millions. From treating deadly infectious diseases such as tuberculosis and pneumonia, antibiotics have enabled many modern clinical procedures including cancer chemotherapy, advanced surgery and organ transplantations, vastly improving human health and lifespan.
But this medical advantage is being eroded, as bacteria are rapidly developing resistance to antibiotics. The emergence of resistance is a natural biological phenomenon but has accelerated due to a number of factors.
The overuse and misuse of antibiotics – in agriculture and medicine – has led to a growing number of bacteria in humans, animals and the environment, that are resistant to antibiotics. Certain strains of tuberculosis, Staphylococcus aureus, and Clostridium difficile no longer respond to antibiotics that used to be effective against them. Additionally, we are seeing the worrying emergence of multidrug-resistant bacterial strains which have shown resistance to many, or even all, available antibiotics.
Antibiotics can treat bacterial infections, but they are ineffective against viruses. According to a WHO survey in November 2015 almost two thirds of people wrongly believe antibiotics can be used to treat colds and flu, which are caused by viruses. Additionally, livestock are also given antibiotics in some countries to promote growth and this exposure helps to drive bacterial resistance. It is vital that we only use antibiotics only when necessary, that way they are more likely to work when we need them.
A global threat
Antimicrobial resistance, or AMR, is now recognised as one of the most serious global threats to human health in the 21st century with bacteria’s resistance to antibiotics increasingly spreading from one country to the next. Without effective antibiotics, most medical practices, including routine surgery, emergency operations, transplants, and chemotherapy will be less safe and in a post-antibiotic era even minor infections could prove fatal. A 2014 review estimated that by 2050 the global cost of AMR will be up to $100 trillion and could account for up to 10 million extra deaths a year.
What are the solutions?
As well as ensuring we use antibiotics only when necessary and appropriate, scientists are working together across the globe to find solutions to AMR. If we are to succeed it is vital that researchers across the science disciplines can work together from diverse fields such as medicine, agriculture, farming techniques, and human behaviour. People who study microbiology, genetics, genomics, data science and medicine will need to come together with economists, social scientists, ecologists, environmental biologists, and anthropologists to understand how resistance has developed and spread. This knowledge will then need to be shared with chemists, synthetic biologists, materials scientists, biomedical engineers, physical scientists, and clinicians from both academia and industry, so new preventives, diagnostics and treatments can be developed.
We will need to investigate the uptake and use of new treatments, how they are being implemented, and how we can ensure appropriate stewardship to prevent resistance occurring.
Bringing the sciences together is key but it is also vital that we work together internationally. As antimicrobial resistance crosses international borders, so must our research efforts. Working with our UK and international partners, the MRC plays a central role in enabling the cross-science and international collaborations that will deliver the solutions to what is a very urgent and global problem.