Antimicrobial Resistance

Peter Dowd Excerpts

Wednesday 17th April 2024 Westminster Hall

[Peter Dowd (in the Chair)]

I call Will Quince to move the motion and then I will call the Minister to respond. There will not be an opportunity for the Member in charge to wind up, as is the convention for 30-minute debates.

[Will Quince (Colchester) (Con)]

I beg to move,

That this House has considered antimicrobial resistance.

It is a pleasure to serve under your chairmanship, Mr Dowd. Until November last year, I had the privilege of serving as Minister of State at the Department of Health and Social Care, alongside the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), who I am pleased to see here in Westminster Hall today. If I may say so, Mr Dowd, it was a pleasure to work alongside her.

My hon. Friend will know that the DHSC is a Department where, despite one’s best efforts, one spends a considerable amount of time firefighting and dealing reactively with issues. During my time in the DHSC, many pressing issues concerned me, some of which remain today, but one in particular scared me.

If I told the House that there was an issue that was so serious that it is a top World Health Organisation global health threat, that it sits on the UK’s national risk register and that it costs the NHS around £180 million a year, would we be surprised if I also said that most people were not aware of it? What about if I said that globally there were 4.95 million deaths associated with this issue and that 1.27 million of those deaths were directly attributed to it? What if I said that one in five of all those deaths were of children under the age of five? Or how about if I said that deaths in the UK related to this issue are estimated to stand at 12,000 per year, which is the equivalent of deaths from breast cancer? What if I told the House that 10 million people—I repeat that figure; 10 million—are predicted to die globally each year by 2050 because of this issue if urgent measures are not taken?

This debate is about antimicrobial resistance, or AMR. If we walked out into Parliament Square now and asked 100 people at random what “AMR” is, I wonder how many of them would know. For the reasons that I have just set out, we should be aware of AMR and concerned about it. We should be pushing our Government, Governments globally and the World Health Organisation to do more to highlight this top global health threat and to take steps to address it.

AMR occurs when bacteria, viruses, fungi and parasites no longer respond to antimicrobial medicines. As a result of drug resistance, antibiotics and other antimicrobial medicines become ineffective and infections become difficult or indeed impossible to treat, therefore increasing the risk of disease spread, severe illness, disability and—sadly—death. Although resistance is a natural phenomenon and not just a health issue, from a human healthcare perspective it is accelerated by inappropriate use of antimicrobial drugs, poor infection prevention and control practices, a lack of development of new antimicrobial drugs and insufficient global surveillance of infection rates.

As I have said, the World Health Organisation has declared AMR to be one of the top 10 global health threats, and it is also listed on the UK Government’s national risk register. In 2019, there were 4.95 million deaths associated with bacterial AMR across 204 countries, and 1.27 million of those were directly attributable, leading the WHO to declare it a top public health threat.

The OECD has found that one in five infections—I repeat: one in five infections—is now resistant to antibiotics, with the potential for that rate to double by 2035. In 2021, there were 53,985 serious antibiotic-resistant infections in England, which represented a rise of 2.2% from 2020. If left unchecked, resistance to third-line antimicrobials—the last-resort drugs for difficult-to-treat infections—could be 2.1 times higher by 2035. That means that health systems will be closer to running out of options to treat patients suffering from a range of illnesses such as pneumonia and bloodstream infections. Despite that—this is the really concerning part—no new class of antibiotics has been developed since the 1980s. Preserving and optimising our current antimicrobial arsenal is therefore not just urgent but paramount.

The consequences of AMR are huge. For urinary tract infections caused by E. coli, one in five cases exhibited reduced susceptibility to standard antibiotics. That is making it harder to effectively treat common infections. AMR also presents a threat to malaria control. Antimicrobial resistance is putting the gains of modern medicine at risk, because it makes surgical and medical procedures that are a normalised part of everyday life—such as caesarean sections, cancer chemotherapy and hip replacements—far more risky.

In addition to causing death and disability, AMR has significant economic costs. AMR creates the need for more expensive and intensive care, affects the productivity of patients or their caregivers through prolonged hospital stays and—I appreciate that this is a side issue—harms agricultural productivity. The World Bank estimates that AMR could result in $1 trillion of additional healthcare costs by 2050 and $1 trillion to $3.4 trillion of GDP losses per year by 2030.

Considering the huge risk that AMR poses to health security across the world, I do not believe that enough is being done globally to combat the current inevitability. Let me start by praising the UK Government for their action in this space, in particular the AMR five-year national action plan, or NAP, to contain and control AMR by 2040, which the NHS long-term plan details commitments to implement. I look forward to the update beyond 2024, which this period goes up to.

I could focus the rest of this speech on what more the UK could and arguably should be doing. We do need to see more on robust monitoring and surveillance. We need a significant public awareness campaign, greater investment in diagnostics, monitoring and screening—particularly in relation to rapid point-of-care testing—at local system level and, vitally, greater focus on infection prevention and management. However, I want to spend the rest of the time available to me focusing on international efforts and the role that the UK can play.