Antimicrobial Resistance

Debate between Gary Streeter and Theresa Villiers

Tuesday 7th December 2021 Westminster Hall

[Theresa Villiers (Chipping Barnet) (Con)]

It is a pleasure to serve under your chairmanship, Sir Gary, and to follow my hon. Friend the Member for Thirsk and Malton (Kevin Hollinrake), whose track record on this important issue is second to none. I warmly congratulate him on securing more time in this Chamber on this important issue.

“Before Alexander Fleming discovered penicillin in 1928, an infection from a simple cut could mean the end of life. Nearly 100 years later, the antibiotic safety blanket we live our lives with is being pulled from us.”

That is a quote from the former chief medical officer, Dame Sally Davies, on the threat posed by antimicrobial resistance. She and many others have spoken out in apocalyptic terms about the catastrophe ahead of us if we do not stem the tide of infections resistant to treatment with antibiotics, as my hon. Friend has so articulately put it.

[Sir Gary Streeter (in the Chair)]

Order.

--- Later in debate ---

[Sir Gary Streeter (in the Chair)]

We will get under way. I know Karin Smyth is not here, but I am sure she will pick up the pace of the debate when she returns. The debate may now continue until 5.55 pm.

[Theresa Villiers]

I started my speech by referring to the remarks of the former chief medical officer, and I was about to say that she is entirely right to have spoken out on this issue. It is not just some millennium-bug anxiety about something that might or might not happen in the future, because people are already dying. Every year, an estimated 50,000 people die from drug-resistant infections, and that number will grow massively unless we deal with the problem.

During lockdown, many of us will have viewed the video of Bill Gates’s warning about a global virus pandemic, which was made years before it actually happened. If action is not taken now on a global scale to deal with AMR, people will look back on Dame Sally’s predictions in the same way. They will say that leading scientists highlighted the potential return to the days when routine surgery, childbirth, a cut in the arm or even an insect bite could give rise to a serious risk of death, and they will ask why we did not act. The good news is that a great deal of action is under way. The O’Neill report, commissioned by David Cameron, was groundbreaking. It was highly influential around the world, and 135 countries have finalised action plans on tackling AMR.

This year, it is very welcome that the UK Government have been using their G7 presidency to try to deliver more tangible progress, as they did last time they held the presidency, in 2013. However, the fact is that developing new antibiotics is massively expensive. The attempt to do so has already forced a number of smaller firms into insolvency and caused some bigger companies to exit their research and development programmes in this area. The fact is that many hundreds of millions of pounds can be pumped into R&D, with no return on that investment whatever if a project turns out to be unsuccessful.

The high failure rates of antibiotic development apparently leave just 40 antibiotics in clinical trials globally. The problem is compounded by the fact that if a new antibiotic is successfully discovered, we want to use it as sparingly as possible, keeping it for serious conditions and to head off potentially worsening AMR problems in the future. That creates even more problems with the risk-return ratio. There is therefore an urgent need for policy reforms to create market conditions that enable sustainable investment in antibiotic innovation, including properly valuing and paying for new antibiotics.

It is very encouraging that the industry has set up a £1 billion investment fund to try to bridge the funding gaps, particularly for smaller biotech companies, that will have a strong focus on drugs that could have the maximum impact in securing and safeguarding public health. Also welcome is the AMR project, which we have already heard about from my hon. Friend the Member for Thirsk and Malton. The project, launched by the UK Government, NICE and NHS, is trialling a new subscription-style model for antibiotics. Under the model, payment is based on the product’s overall value to the NHS, rather than on just counting the pills dished out to patients. Two medicines have been selected, and contracts are expected to commence in April 2022.

It is very welcome that the project has continued despite the pandemic, but we now need to press ahead with wider implementation in order to cover more research and bring in the devolved nations, so that we have a whole-country approach. We need the project to get beyond the pilot stage, and we need to learn from it to ensure that a sustainable solution is put in place for new antibiotics that reflects their long term value to society as a whole.

In conclusion, I very much welcome the leading role that the UK Government have taken on this issue on the world stage. However, if we are to succeed in addressing this great challenge of our time, there is still a lot of work to be done. For example, we need to increase public understanding of the dangers of over-prescribing or misusing antibiotics. We must also tackle the overuse of antibiotics in farming. I do not see that as a domestic problem with our sector—we have strict rules to prevent that from happening in UK farming—but we need to use our trade and foreign policy to raise standards on antibiotics use in agriculture all around the world.

Above all, the Government need to be bold and ambitious in putting in place a long-term market solution that changes how we pay for antibiotics, so that we can reward and incentivise the scientific research that can save us from the nightmare we face: a return to Victorian medical outcomes, where 40% of our population have their lives cruelly cut short by infections we cannot treat. I look forward to hearing from the Minister what action the Government are going to take to drive this crucial issue forward.