Antimicrobial Resistance

Jim Shannon Excerpts

Wednesday 17th April 2024 Westminster Hall

[Will Quince]

I thank my right hon. Friend for bringing that to my attention; it was not something that I was aware of. Given the gravity and seriousness of the situation that we face not just here in the United Kingdom but globally, I think that we need to look at all potential tools in the arsenal to tackle this issue, so I hope that the Minister has heard the case that my right hon. Friend has made very powerfully, and I would be happy to meet with him afterwards to find out more about it, because it sounds incredibly interesting.

My right hon. Friend is right—although I want to focus for some time on the international effort—the battle is not won here in the UK, we have far more to do, and the Department of Health and Social Care and NHS England have important roles to play. I know from first-hand experience, including when representing His Majesty’s Government at the World Health Assembly and the United Nations General Assembly when I was Minister of State, the global leadership that the UK shows through the World Health Organisation, especially in partnership with Sweden. During my time, I was proud to be able to announce an investment of £39 million into research through the global AMR innovation fund to help to tackle what is a silent pandemic. I understand that £24 million of that has been awarded to bolster the UK’s partnership with CARB-X, which is a global AMR research initiative that supports the continued early development of invaluable new antibiotics, vaccines, rapid diagnostics and new products that combat life-threatening, drug-resistant infections, as well as prevent death and disease across the world.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Gentleman for bringing the debate forward. The issue has been in my mind for some time, and I have a number of questions about antibiotic use, which, as I understand from the stats and from questions to the Department and Ministers, has been increasing greatly. Does the hon. Member agree that during covid a standard was set whereby many GPs and out-of-hours practices had to prescribe antibiotics without seeing patients? We need to return to the prescription of antibiotics after an examination that determines whether they are absolutely necessary. We cannot keep on giving them out willy-nilly; we have to do it under strict control.

[Will Quince]

The hon. Gentleman makes a valuable point; he is absolutely right that we need to readdress our approach to antibiotics. Yes, there is a role for clinicians in that. A 10-minute slot is not a lot of time to diagnose. Lots of people will go to see their doctor and the first thing they will say is, “I have an infection; I need antibiotics.” That may not be the case, and we have to trust clinicians. The Government’s new Pharmacy First initiative, which pharmacists take seriously, has strict controls and surveillance around the use of antibiotics; the UK Government and the Department of Health and Social Care take that incredibly seriously.

The hon. Gentleman is absolutely right to allude to the fact—and this is what worries me—that, in many countries around the world, antibiotics are available off the shelf, in the same way that paracetamol or ibuprofen are. I will not name the country, but I spoke to the Health Secretary of a particular country in Africa, who said that people routinely keep antibiotics in their medicine cupboard at home; if they feel unwell, they will take a few. That causes huge problems. We need an enormous awareness campaign and education piece around antibiotics, because their use may be harming us all in the medium to long term.

I also want to touch on the Government’s Newton fund, which has supported more than 70 research teams to conduct crucial research on strategic areas, including AMR. Through the brilliant Fleming Fund, the Government have invested £265 million to support countries around the globe to generate, share and use data on AMR. I am proud that that is the world’s single largest aid investment in AMR surveillance. I also must not fail to mention the role played by Dame Sally Davies, who is the UK’s special envoy on antimicrobial resistance. At the WHA and the UN General Assembly, I saw at first hand Dame Sally’s global leadership and how widely respected she is on the world stage on this issue. We are very lucky to have her.

Internationally, there is movement. I welcome the landmark 2015 WHO global action plan on AMR, which was followed in 2016 by the historic UN declaration on AMR and, more recently, the one health global leaders group on AMR, founded just a handful of years ago to provide leadership and maintain political momentum on the issue. But I believe the issue is so serious that more urgent and immediate action needs to be taken. As I said to the hon. Member for Strangford (Jim Shannon), we know there are countries where antibiotics are routinely kept in cupboards and medicine drawers at home and taken when people feel unwell. We know there are countries where antibiotics can be purchased over the counter or online without seeing a doctor or physician. My question to the Minister is what action could and should we be taking?

I think we need a significant domestic and international awareness and understanding campaign on AMR. We need the Governments in our respective nations to understand the risks of failure. We need the public to understand the impact on them and their families, and the urgency of the situation: we want them to be the ones calling for action. We need to do more to promote appropriate and adequate global surveillance for AMR to detect and strengthen our knowledge and evidential base. Incidentally, doing that will also help with identifying potential future pandemics, so there is a dual benefit.

We need to work towards an international agreement on common evidence-based goals, and support other countries to deliver against them. We have to use our official development assistance—our overseas aid budget —to help reduce the incidence of infection through effective sanitation, hygiene and infection prevention measures. To the best of our ability, we need to use the UK’s political positions on international platforms and our soft power, including our ODA spend, and of course the formidable Dame Sally Davies and our UK expertise, to continue to provide global leadership on AMR. I hope the Minister will commit to supporting and continuing to fund the work of the World Health Organisation on AMR.

I hope that in the short time available to me—I appreciate that it was shorter because I was racing to get here in time following the votes—I have been able to set out why antimicrobial resistance is the issue that concerned me most when I was Minister of State at the Department of Health and Social Care and why it continues to concern me on my glide path out of politics. I genuinely think it should greatly concern us all. I hope the Minister and future Ministers will continue to keep the issue front of mind and treat tackling it with the urgency and seriousness it deserves.

--- Later in debate ---

[Maria Caulfield]

That goes back to my first pillar of reducing and preventing infections in the first place. We need to do that domestically, but internationally we are also doing huge amounts of work in that space to improve water sanitation. With animal health, too, we have done a huge amount of work, in particular on antibiotic use in food. Among animals used in food production, the UK has reduced by 59% the amount of antibiotics going into the food chain, which has a knock-on effect.

We are also investing in innovation and capitalising on our world-leading science, including phage therapy, as my right hon. Friend the Member for Tunbridge Wells (Greg Clark) pointed out. I had not heard about the Leamington Spa facility, and I am interested to catch up with him after the debate to see what more can be done. The National Institute for Health and Care Research is investing almost £90 million in that type of research, so if there is potential to develop that further, we are always keen to hear it. Our plan is cross-sectional, a one health approach, recognising the links between the health of humans, animals and the environment, and the spread of resistance between them.

We have a national action plan, which is not limited to activity in the UK. We all know that infections do not respect borders. As my hon. Friend the Member for Colchester said, we are therefore working internationally and taking a lead in many elements of that across the global community, with our UK special envoy on antimicrobial resistance, Dame Sally Davies, spearheading some of the effort. On updating my hon. Friend on the action plan post 2024, we are working it up as we speak and hope to make an announcement soon. There is an ongoing piece of work to drive forward some of the changes across the three sectors.

We are doing our bit here and are leading internationally, but my hon. Friend also touched on what is happening in other countries. Low and middle-income countries have to be part of the change so that we can safeguard ourselves against antimicrobial resistance.

[Jim Shannon]

One of the groups that I speak to reminded me to mention—I quote—

“the need for Group B Strep screening in pregnant women during labour instead of using antibiotics for all routinely.”

The Minister is interested in that subject and has an opinion on it. Does she agree that this is a chance to raise awareness of that particular issue?