According to the report, the government is taking the problem seriously, with AMR identified as one of 26 chronic national risks. But, despite a 20-year vision, a cross-government approach and some innovative solutions, including subscription arrangements for procuring antibiotics, the UK remains a long way from the vision and objectives the government expressed in 2019: a lower burden of infection; the optimal use of antimicrobials; and new treatments so that everyday illnesses can continue to be cured.
Of five domestic targets set in 2019, only one – reducing the use of antibiotics in food producing animals – was met. Drug-resistant infections in humans have increased by 13% since 2018, despite a target to reduce them by 10%.
‘Antimicrobial resistance presents a major public health threat and addressing it is a multifaceted challenge. Government is responding but, so far, the results have been limited and the country needs to become more resilient to this long-term risk,’ said Gareth Davies, head of the National Audit Office.
The COVID-19 pandemic and demographic changes have complicated efforts to combat AMR. Patients are arriving in hospital with more pre-existing conditions and staying for longer, leading to an increase in the potential for opportunistic infections4. The condition of the NHS estate has also seriously deteriorated in recent years, which can make it harder to keep buildings clean and isolate infectious patients.
It is not clear that health workers and the public yet have sufficient awareness of the threat AMR poses. In 2018, only 49% of the UK public knew that antibiotics do not work against viruses and there is limited evidence so far of the impact of public awareness campaigns.
NHS England has made progress with trialling a subscription model to procure antibiotics, which could incentivise the development of new drugs. The results of this important new approach, set to cost an estimated £1.9 billion for supplying these antimicrobials to the NHS over 16 years, need to be carefully tracked and evaluated.
‘[The] Government needs to consider whether its existing commitments and other efforts across the public sector will be enough to achieve its 20-year vision to contain and control AMR,’ added Mr Davis.