Antimicrobial Resistance

Baroness Greengross Excerpts

Thursday 2nd May 2019 Lords Chamber

[Baroness Greengross (CB)]

My Lords, first, I congratulate the noble Lord, Lord Lansley, on securing this very important debate. My interest in this issue is partly due to the work I do through the International Longevity Centre UK, which I established 20 years ago. It is one of 16 organisations across the world which looks at these sorts of issues. The ILC-UK, following the UN’s high-level meeting in 2016, held its Jack Watters memorial debate on the subject and produced a report on antimicrobial resistance in 2017. That report links to one of the ILC’s other key workstreams: the promotion of vaccines. I chaired a meeting on that vital issue in this House only last month.

This debate is very timely given that the Government published their new five-year plan in January of this year. There is now renewed vigour from the Government to tackle this issue. I hope that it will be tackled because, as noble Lords have said, this is a major, worldwide challenge and it needs to be taken very seriously. I cannot overemphasise that. The health of our whole population is at risk, but especially that of older people, who are more vulnerable to illness and disability than younger people. I was grateful to receive certain facts and figures from the British Society for Immunology, which points out:

“AMR could turn back the clock a century on medicine”.


It is of course alarming to read in the action plan that AMR might already cause 700,000 deaths every year worldwide and that this could rise to 10 million by 2050, which is partly why I welcome how seriously the Government are taking this issue. The UK has been a world leader, from David Cameron taking the issue so seriously back in 2013 to the review from the noble Lord, Lord O’Neill, in 2014 and the work of Dame Sally Davies, which we have mentioned, as well as useful scrutiny from both Houses of Parliament. Now at last we have the new action plan.

In my brief remarks I will focus on the action plan’s acknowledgement of the importance of vaccination’s preventative role and how we might better stimulate R&D into vaccines. While encouraging the development of new antibiotics is obviously sensible, as the noble Lord, Lord O’Neill, recommended, the ILC report agreed with his other recommendations to develop new vaccines and use existing ones more effectively as a way of reducing dependency on antibiotics.

The World Health Organization has calculated that, if coverage of existing vaccines was increased, millions of days of antibiotic use could be prevented. For example, if flu vaccination rates increased, antibiotic use would surely reduce as the incidence of flu fell, as well as from a decline in secondary infections caused by flu, such as ear or sinus infections. In the ILC’s Jack Watters debate, Professor David Salisbury argued that there was “no debate” about whether more should be done to increase the coverage of a wider range of vaccines across the life course. I very much agree with that. I note that the O’Neill review calculated that vaccine programmes save society 10 times their original cost.

The list of potential new vaccines that Professor Salisbury hoped to see developed in coming years ranged from Alzheimer’s to respiratory syncytial virus, as well as more obvious ones such as norovirus and TB. As the British Society for Immunology has pointed out, vaccines are the most preventative health tool in human history. Like me, it also wants to see significant investment in novel vaccine research, in particular into bacterial infections such as pneumonia and sepsis—I am a member of the All-Party Group on Sepsis.

This is why I hope the Minister can reassure me that the action plan will help to create the right environment to incentivise the science community on vaccine development, which historically has a poor commercial return on such investment. I was struck by what the Society for Immunology said in its briefing: that less than 5% of pharma venture capital investment over the past 10 years went into AMR. I hope that research on vaccine development is not held back by the focus on developing an AMR of “last resort”, the return of which is uncertain, and for recognition that a co-ordinated cross-government approach across all relevant sectors is urgently required if this is to be achieved.