Antimicrobial Resistance

Baroness Masham of Ilton Excerpts

Thursday 2nd May 2019 Lords Chamber

[Baroness Masham of Ilton (CB)]

My Lords, I thank the noble Lord, Lord Lansley, for this most necessary debate, which covers vital aspects of life and death. So much parliamentary energy and time has been spent on Brexit that a subject as important as antimicrobial resistance has not been as prominent as it should have been on the parliamentary agenda. However, I congratulate Professor Dame Sally Davies, the Chief Medical Officer, for what she has done to help the UK become one of the world leaders in the subject. Antimicrobial resistance is a world dilemma. Governments across the globe should work together and treat this as an emergency problem which must be solved.

The World Bank has predicted that globally, AMR will lead to increases in morbidity and mortality, increase the burden on healthcare systems, increase extreme poverty and could inflict heavy losses on the global economy. The European Medicines Agency’s leaving London for Amsterdam does not give a good message to the world about our status in leadership, new medicines and safety. We will not have voting rights. We will be second-class members if we leave the EU.

I must declare an interest. I had sepsis last June, and know only too well the difficulties of combating infections. Sepsis needs quick diagnosis and antibiotics, but there is a problem getting the correct antibiotic for the appropriate infection. One needs accurate, rapid tests. After nearly a year, I am still battling an infection which persists in going up and down—even though I have the help of three hospitals and the advice of a cousin in Australia, who is a professor of microbiology. I mention this to illustrate how challenging these infections are, especially if they are resistant to treatment. During the year, I have witnessed the stress and pressure some hospital departments are under. The shortage of experienced staff and the difficulties of communication are of concern. There is no doubt that Brexit is not helping. Many much-needed nurses and doctors come from Europe. Many of our doctors and nurses go abroad, where the grass seems to be greener. One never knows what infection will emerge.

I would be grateful if the Minister could tell your Lordships what the Government recommend about Candida auris. The Sunday Times has said that:

“Eight patients in hospitals in Britain have died after becoming infected with Candida auris, the deadly Japanese super-fungus”.


The revelation by Public Health England illustrates the scale of the threat from the super-fungus, which emerged just 10 years ago in Japan, equipped with the fearsome biological armoury that lets it flourish in hospitals and resist most drugs and disinfectants. To date, the microbe has been found in at least 25 British hospitals. What seems to make Candida auris unique is that it spreads so easily from person to person. Once in the bloodstream, it circulates and multiplies, causing sepsis. I congratulate the UK Sepsis Trust for trying to make Parliament, hospitals, GPs, schools and the general public at large aware of sepsis.

With antimicrobial resistance, it is vital that we get new antibiotics. However, a disaster is unfolding in the antibiotics market. In the global struggle against superbugs, Achaogen is a biotech at the front line. Its failure is the latest symptom of an ailing antibiotic market. Its antibiotic, plazomicin, was, in 2018, approved by the UK food and drugs administration for treating complex urinary tract infections caused by drug-resistant bacteria. It is a vitally needed drug, and just one of many new antibiotics we need to replace drugs that are rapidly losing their effectiveness against superbugs. Its loss, for lack of funding, is a tragedy. This was mentioned by the noble Lord, Lord Lansley, and I think it is worth mentioning again.

On a more hopeful note, Carb-X, a global partnership dedicated to accelerating research to tackle the global rising threat of drug-resistant bacteria, with up to £550 million to invest, is said to fund the best science around the world. Its portfolio is the world’s largest development pipeline of new antibiotics, vaccines, rapid diagnosis and other projects to prevent and treat life-threatening bacterial infections. It is encouraging that the UK, the USA and Germany, and several trusts and foundations, are working together. The headquarters are at Boston University. I hope they have great success in helping to protect humanity from the most serious bacterial threat before us. We need better preventive measures as well as alternative treatments, including innovative ways to use the body’s own immune system and healthy bacteria.

I am trying a new treatment for wounds—Acapsil. It is micropore particle technology, a white powder applied to the wound surface. It consists of small particles composed of a network of very fine pores. It removes the toxins, and enzymes are excreted by the wound surface. It does not kill the micro-organisms. It is hoped that it is effective on antimicrobial-resistant infections. Another exciting discovery is that golden kelp, the common seaweed from the rocky shores of Mindelo in northern Portugal, has been found to contain microbes that could bolster the war on superbugs.

I would like to ask three questions. First, what are the Government doing to speed up detection of AMR throughout the NHS? Secondly, do the Government recognise the value of accurate antimicrobial susceptibility testing in safeguarding the remaining effective antibiotics, while accurately monitoring the newly emerging AMR and screening potential new antibiotics? Thirdly, are they aware that the Central Public Health Laboratory in Colindale is involved in an international consortium that has developed a rapid antimicrobial susceptibility test, but that in over two years it has received no direct funding to establish that test capability here?

I have a farm and pony stud. I support vets by saying that they should have the right to prescribe and dispense veterinary medicines, including antimicrobials, according to their responsible clinical judgments. The welfare of animals, as well as humans, must be paramount.