Antimicrobial Resistance

Baroness Redfern Excerpts

Thursday 2nd May 2019 Lords Chamber

[Baroness Redfern (Con)]

I thank the noble Lord, Lord Lansley, and congratulate him on securing this debate on the incredibly important topic of addressing AMR. It is absolutely essential to see AMR as the economic and security threat that it is.

I will talk first about animal husbandry. The Government must make a clear commitment that any future trade deals will require any meat and dairy produce imported into the UK to meet at least the same standards relating to antibiotic use that apply to meat and dairy products produced in the EU, because over 40% of the UK’s total antibiotic use is in animals.

Contamination can occur from animal waste, human waste, pharmaceutical manufacturing and the use of antimicrobial pesticides on crops. There is no doubt that more funding is needed on AMR to kick-start early research into new antimicrobials and diagnostics. We must conduct in-depth research to better understand the impact of AMR pesticide exposure on humans, animals and the surrounding environment, and identify and promote best management practices to minimise exposure when applying antimicrobials as pesticides. There should also be more global transparency over antimicrobial use on pesticides, by collecting and sharing information on the amount and types used on crops each year. Sharing knowledge is so important.

We now see antibiotics reaching the environment in many ways, such as through sewage run-off and the run-off from food producing units such as farms. In particular, there is the impact of effluent from factories on our nearby water systems. Action is needed, too, so that regulators can set at least minimum standards for the treatment and release of manufacturing waste, and drive much higher standards through supply chains. It is vital that we have better commercial return on R&D; it is little wonder that firms are not investing in antibiotics, despite the very high medical needs. We need new ways to reward and enhance innovation.

What matters now is that action should support reducing the unnecessary use of antimicrobials and, I emphasise, revive investment in their development. Rapidly growing global demand for antibiotics is necessary to improve access to life-saving medicines, along with economic development. But all too often it reflects excessive and unnecessary use, rather than genuine medical need, so by reducing unnecessary consumption we can have a powerful impact on resistance. Educators, farmers, the veterinary and medical communities and professional organisations need to pledge to make better use of antibiotics and help save vital medicines from becoming obsolete.

The rise and spread of antimicrobial resistance is, as we have heard this afternoon, creating a new and potentially dangerous generation of superbugs. The UK needs to help ensure that AMR remains a global priority by continuing to lead international policy. As we have been informed, by 2050 it is estimated that AMR will kill 10 million people per year—more than cancer and diabetes combined. That is the scale of the threat that we face. The ambition for AMR is, by 2040, to have new diagnostics, therapies, vaccines and interventions in use, together with a full AMR research and development pipeline for antimicrobial alternatives, along with diagnostics, vaccines and infection prevention across all sectors.

Government and other funders must act to ensure that the market can offer sufficient commercial incentive to keep pharmaceutical companies active in this space. They should conduct studies to evaluate the effectiveness of existing wastewater treatment processing in the removal from it of antimicrobials before its discharge into environmental waters, and investigate and identify the factors that result in treatment inefficiencies and failures in processing methods, or the infrastructure failures. Studies have found APIs in rivers, treated and untreated manufacturing wastewater, and sediment downstream of industrial wastewater treatment plants.

We have evidence, too, of the clear priorities that will support greater progress in addressing antimicrobial-resistant microbes in the environment. As I mentioned earlier, high-risk areas, such as the disposal of waste from healthcare facilities and manufacturing, could be prioritised and addressed at local and global levels to reduce the potential risks to human health posed by having those microbes in the environment. Unfortunately, we have not seen a new class of antibiotics for decades, because an overuse of antimicrobials has increased the rate at which resistance is developing and spreading. Again, we lack the new drugs to challenge these new superbugs. Governments and other funders must act to ensure the antimicrobial market can offer sufficient commercial incentives to keep pharmaceutical companies active in this space. Where testing is clinically appropriate and recommended by NICE, action should be taken to address the perverse financial incentives that may discourage use. I emphasise that we must work in collaboration to improve national and international understanding. We have a major global challenge ahead of us.