Quadram Institute welcomes new UK 5-year action plan for antimicrobial resistance

24th January 2019

At the World Economic Forum at Davos, Secretary of State for Health and Social Care Matt Hancock MP announced the UK’s five-year national action plan for tackling antimicrobial resistance (AMR). Within Quadram Institute Bioscience, understanding antimicrobial resistance is a key research priority for our Microbes in the Food Chain programme. Our collaborative, interdisciplinary approach involves investigating patterns of resistance genes to identify the evolutionary selective pressures that drive AMR emergence. This knowledge will be applied to the development of novel interventions to reduce AMR. Our research will support calls within the plan for rapid diagnostics using innovative techniques and enhanced surveillance of both human and animal antibiotic consumption using bioinformatics and a more robust pipeline supporting the development of new antimicrobials..

It is welcome to see the government’s recognition of the importance of antimicrobial resistance as a threat to global health and the identification of these priority areas for future research. This builds on the progress made in the last five years to reduce antibiotic use in humans and animals and the efforts made to start integrating surveillance data to best understand where resistance is being selected and how resistant organisms and resistance genes move between bacteria and people.

The national action plan for the next 5 years aims to consolidate the work already undertaken but also has a greater emphasis on the development of new therapies to prevent or rapidly identify infection and ideas about a new model to help develop novel antibiotics. This recognises the current inertia in drug development and the need for new antibiotics.

Antibiotic development is a global problem and the report states the UK will work with international partners to incentivise new antibiotic development.  Whilst the specifics are unclear this is a positive step but it will be a major undertaking. There is no short fix if we are to realise the ambition of a pipeline delivering a number of drugs. As well as incentivising big pharmaceutical companies to again invest in developing antimicrobials, support is also needed for the smaller organisations and SMEs who have promising initial discoveries but lack the resources for 10 years of commercial development.

The UK government’s five-year AMR action plan highlights the importance of rapid diagnostics, detailing plans for incentivising R&D and improving rapid uptake. The report identifies a number of technology gaps that QIB are in an excellent position to fill. We have a number of ongoing research programmes on the rapid diagnosis of pathogens in humans, food and the environment. These programmes are driving the development and adoption of new diagnostics technology for infection and AMR, which will reduce patient morbidity and mortality, improve food safety and reduce pathogen transmission.

The report emphasises the importance of basic research such as that undertaken within QIB to understand potential drug targets, the drivers that make some strains resistant, and the role of the microbiome.

The recognition of the need for improved food safety and a better understanding of AMR in the food chain is highly relevant to ongoing work within QIB and we look forward to contributing evidence to help advance this knowledge base.

The action plan recommends strengthening laboratory capacity and surveillance of AMR in animals and in humans. The UK now has good surveillance relating to patient data, but to fully understand the drivers of AMR emergence and its transmission we need to extend that surveillance to animals, the food chain and the environment, especially those that have been less well studied in the past. This will fill in the gaps in our knowledge to enable a bigger picture of a AMR based on the One Health vision. It’s welcome to see the action plan emphasising the value of long term surveillance programmes, as this allows us to identify shifts and patterns over time providing more information of AMR emergence.

AMR research is already benefitting from the use of the latest genomic, metagenomic and bioinformatic techniques. The UK has world-leading expertise in these areas. Quadram institute Bioscience has invested in its bioinformatics capabilities to bring these cutting edge techniques to the study of microbes and microbial populations, and in particular the resistome (the complete set of resistance-related genes from a sample).

QIB’s focus on the microbiome is relevant to AMR study, as we need to understand how our own resident microbes protect against antimicrobial-resistant pathogens. With this, we will look at ways of combatting AMR infections based on helping our own microbiome exclude these resistant pathogens.

In launching the UK’s five year national action plan at the World Economic Forum at Davos, Matt Hancock rightly identifies AMR as a global health crisis. The action plan sets out the UK’s local, national and international response to this global crisis, as action is needed unilaterally across nations, sharing data and best practice, encompassing a One Health approach that’s essential given the interconnectivity of microbes across human, animals and the environment.