Antibiotics: Research and Development

Carol Monaghan Excerpts

Tuesday 26th April 2016 Westminster Hall

[Carol Monaghan (Glasgow North West) (SNP)]

It is a pleasure to serve under your chairmanship, Mr Evans. I congratulate the hon. Member for York Outer (Julian Sturdy) on securing this important debate on an issue that is not well enough known or understood.

Tackling the over-consumption of antibiotics is one of the greatest health challenges of this generation. Alexander Fleming warned in 1945 that micro-organisms could develop resistance to antibiotics. Unfortunately his prediction proved to be correct. A report published by the World Health Organisation in 2014 said antibiotic resistance was now “a global threat”. The hon. Member for Strangford (Jim Shannon) described that threat to global security as being on a par with other, better-known threats. The US Centres for Disease Control have pointed to the emergence of “nightmare bacteria”, and Professor Dame Sally Davies has evoked parallels with the apocalypse. The hon. Member for York Outer mentioned that antimicrobial resistance is estimated to kill more than 700,000 people globally every year—a horrifying figure to us all, I think.

A number of hon. Members, including the hon. Members for Erewash (Maggie Throup) and for Cambridge (Daniel Zeichner), discussed the inappropriate prescription of antibiotics. The picture in Scotland reflects that in the rest of the UK. In 2014, 55,000 people—1% of the population—were taking antibiotics at any one time, and in up to 50% of cases, they were for conditions that would have got better without them.

Resistance is a natural biological phenomenon, but it is increased and accelerated by various factors, such as the misuse of medicines, poor infection control and global trade and travel. That is a particular concern with antibiotics. Many of the medical advances of recent years, such as organ transplantation and chemotherapy, need antibiotics to prevent and treat the bacterial infections that can be caused by the treatment. Without effective antibiotics, even minor surgery and routine operations could become high-risk procedures. The hon. Member for York Outer talked about a grazed knee becoming a serious condition, and I have personal experience of that, because a small cut to my knee did not respond to antibiotics, and I ended up in a serious situation, needing an operation and fairly strong antibiotics to save my leg. The situation we are talking about is a real one, and a major threat.

Inaction could mean the loss of effective antibiotics, which could undermine our ability to fight infectious diseases. The hon. Members for Poplar and Limehouse (Jim Fitzpatrick) and for Strangford both talked about TB, and the hon. Member for Poplar and Limehouse spoke of the high rates in his previous constituency. As he said, it is a devastating disease, causing 1.5 million deaths worldwide every year. Of most concern are the cases of drug-resistant TB that hon. Members have highlighted.

Action is needed at local, national and global level to improve the knowledge and understanding of antimicrobial resistance, to steward the effectiveness of existing treatments, and to stimulate the development of new antibiotics, diagnostics and therapies. The Scottish Government are taking the issue seriously. In March they announced a £4.2 million research grant to investigate the prevention and control of healthcare-associated infections, and to research new ways to use existing antibiotics more effectively and efficiently. The hon. Member for Strangford spoke about the use of antibiotics in farming and mentioned that some advances had been made in reducing their use. That is certainly positive and praiseworthy.

I welcome the UK Government’s focus on AMR, including the establishment of the independent review led by Lord O’Neill to explore the surrounding economic issues, and I look forward to seeing the review, which I hope will be published next month. It is important to acknowledge that we are simultaneously dealing with a health problem and an economic problem. The Association of the British Pharmaceutical Industry has argued that it would like a clear set of actions to be taken on developing new economic models, in particular through innovative pricing, and reimbursement mechanisms incentivising more investment in the search for new antibiotics.

There are many challenges in the current antibiotic funding landscape. The hon. Member for York Outer talked about the timescale for getting new treatments to market. I think that we would all agree that 15 years is far too long, in both economic and healthcare terms. The expected returns and associated risk with antimicrobials mean that they are not competitive with other therapeutic areas. New, innovative antibiotics often have a low price, as society expects generic antibiotics for treating large numbers of patients to be economical. The hon. Member for York Outer also talked about a fixed price for antibiotics, and perhaps that could be investigated further. The hon. Member for Cambridge talked about the drop in the number of trials of new drugs in the UK. We must ask what the reason for that is. Why cannot trials be carried out in the UK? We must look at the funding for that. I would like the UK to accelerate its leading role in developing solutions to incentivise the development and management of new antibiotics; that would promote investment in antibiotics as well as their appropriate use, and reduce the risks for both the payer and the investor.

Total antibiotic prescribing, measured using daily doses, continues to increase. The Scottish Government have been encouraging everyone to play their part by reducing the unnecessary use of antibiotics, raising awareness, and pledging to be an antibiotic guardian. That campaign aims to increase knowledge of antibiotic prescribing and resistance. It has reached more than 12,000 individuals in the first six months. Those were predominantly healthcare professionals, but everyone can pledge to become an antibiotic guardian at www.antibioticguardian.com. I did it earlier today, and I hope that many hon. Members will do so, too.

The hon. Member for Erewash discussed future public engagement work and how we raise awareness of antibiotic resistance. It is essential that we educate people about when and why antibiotics are needed. That should include helping patients to understand the duration of illness and alternative treatments for common viral infections, such as colds and flu, that do not require antibiotics.

In November 2015, Scotland’s Cabinet Secretary for Health, Wellbeing and Sport, Shona Robison, said that the rise of drug-resistant infections must be tackled around the world. She marked European Antibiotic Awareness Day by pledging to be an antibiotic guardian. The Scottish Antimicrobial Prescribing Group and UK partners have launched their target. Is the Minister willing to sign up to be an antibiotic guardian? When does he plan to launch his public awareness campaign?