Drug-Resistant Infections

Lord Colwyn Excerpts

Thursday 15th September 2016 Lords Chamber

[Lord Colwyn (Con)]

My Lords, I congratulate my noble friend Lord Lansley on securing this debate on what is one of the greatest health and economic challenges of our age. Antimicrobial resistance—AMR—which is causing the rise in drug-resistant infections, is killing around 700,000 people worldwide. In the UK alone, it is resulting in 3,000 deaths a year, with an estimated cost to the NHS in excess of £180 million per annum. Without global action, AMR will kill another 10 million people annually by 2050, according to recent models referenced by my noble friend Lord O’Neill in his recent report on this issue. According to my noble friend’s findings, the increase in death and illness is set to wipe approximately $8 trillion off the world’s annual output by 2050. Previous speakers have referred to Dame Sally Davies, who frightened me when she described the threat of antibiotic resistance as being as great as the threat of terrorism.

The problem has been well documented and assessed; we now need to move on from discussing the problem to supporting the development and rollout of solutions. Policy discussion must go beyond just antimicrobial stewardship and the restriction of the use of existing antibiotics.

I note that at the May 2016 G7 summit, the then Prime Minister stressed the scale of the global problem of AMR and committed the UK to supporting British pharmaceutical companies to be at the forefront of bringing new products to market. Indeed, the report of the noble Lord, Lord O’Neill, called on the Government to provide:

“Better incentives to promote investment for new drugs and improving existing ones”.

I hope that the Minister will be able to reiterate this commitment on behalf of the new Prime Minister. Supporting the development of new antibiotics must be a key policy pillar in the Government’s antimicrobial strategy both at home and abroad.

This afternoon I would like briefly to touch on an example of the types of solutions that exist beyond better antimicrobial stewardship, which is combating AMR at home and abroad. In my career as a dentist, I was aware of some of the important work being done using oxygen in oral health care. I am excited that oxygen is now at the forefront of work to address AMR with the development of reactive oxygen technology.

Reactive oxygen is a British-led innovation which represents a new generation in antibiotics. It works by generating highly reactive, free-radical oxygen species, mainly hydrogen peroxide—one of nature’s fundamental defences against infection. It has been advanced by a small UK company, Matoke Holdings. Its chief executive, Ian Staples, is working with eminent clinicians, researchers and academics across Manchester, Southampton and Birmingham universities, including Dr Matthew Dryden of the University of Southampton School of Medicine and Professor Jonathan Cooke of Manchester University Pharmacy School and Imperial College London. These British scientists have developed a unique technology to precisely control levels and the rate of release of reactive oxygen, harnessing its ability to fight infection. No Gram-negative, Gram-positive or multiresistant bacteria tested to date have survived contact with reactive oxygen in either laboratory or clinic, including MRSA and Pseudomonas aeruginosa.

However, direct use of the gas is prohibited because ozone should not be inhaled. Professor Eddie Lynch, a colleague of mine, has shown that primary root carious lesions can successfully be treated with a novel ozone delivery system able to avoid any toxic risk. The system includes a source of ozone and a dental hand-piece with a removable silicon cup for exposing the tooth’s lesion to the gas. Although it is many years since I observed this treatment, it was very effective, with no side-effects. It could be considered a valid alternative to conventional drilling and filling for the management of primary root carious lesions.

I was delighted to hear from Matoke Holdings earlier this year. Reactive oxygen is one alternative that can play a vital role in tackling drug-resistant infection. The first product from this innovation, Surgihoney RO, is already approved by the EU regulatory body as a topical antimicrobial gel with antibiofilm action for wounds, burns and ulcers, including diabetic, and it has already been prescribed through the NHS. It has also been used by volunteers in Uganda and Ethiopia to prevent and treat infections, taking this British innovation to parts of the world where it is desperately needed. This is made possible given it is a low-cost, effective antimicrobial that is easy to use and does not require refrigeration. But, such innovative products need to be made available more widely to support some of the most vulnerable international communities.

The technology is now rapidly being developed to tackle other complex clinical infections for which conventional antibiotics are failing, including cystic fibrosis, chronic rhinosinusitis and recurrent urinary tract infections. Such technology has huge potential to deliver significant savings to the NHS and international health economies by providing a new effective treatment for chronic wounds, reducing amputations and days spent in hospital and nursing care. Such British innovative technology, which represents a new generation in antibiotics, needs to be brought to the forefront of the policy discussion about how we tackle AMR, both within the UK and globally.

While reactive oxygen technology is being pioneered by one British SME, this needs to be supplemented by strong government support for innovation to address this global challenge at scale and at pace. Investing in British research and development and supporting British enterprise will support our economy and allow us to export solutions to the threat of AMR across the globe. British innovation can still be a leader in the post-Brexit world. I ask the Government to do all they can to put British enterprise and R&D at the forefront of their strategy to combat AMR and to ensure that they look at the innovative new solutions that are already out there.