Global focus on antibiotic resistance

Each year, bacterial infections cause an estimated 7.7 million deaths, the second largest cause of death. Nearly 5 million of these deaths are linked to antibiotic resistance. A series of articles in The Lancet, written by Heiman Wertheim, professor of medical microbiology at Radboudumc, among others, calls for a decisive approach to the problem, partly in view of a United Nations meeting later this year.

'The antibiotic resistance crisis demands more action,' wrote physician federation KNMG about a year ago. 'Bacteria worldwide are becoming increasingly insensitive to antibiotics. This makes effective treatment of infections more difficult, resulting in morbidity, mortality and higher healthcare costs. Antimicrobial resistance is one of the biggest global health threats, causing 1.2 million deaths each year, more than 35,000 of which are in Europe. The European doctors' organization CPME, of which KNMG is part of, is therefore calling on the EU to take more action.'

Dutch Action Plan

Although antibiotic resistance is not always sexy news for the media, it remains a major topical concern for national and international medical and health organizations. Also for the Netherlands. For example, on May 16, 2024, Pia Dijkstra and Piet Adema - the Minister of Medical Care and the Minister of Agriculture, Nature and Food Quality, respectively - presented the Dutch Action Plan for Reducing Antimicrobial Resistance 2024-2030 to the House of Representatives.

Major threat to public health

In the accompanying parliamentary letter, the ministers write, "The emergence and spread of antimicrobial resistance (AMR) is a growing and difficult problem to address worldwide. In fact, the World Health Organization (WHO) calls AMR one of the greatest threats to public health. In the Netherlands, therefore, policies to reduce AMR have been in place for years, working closely with all stakeholders. This approach involves collaboration across the full breadth of One Health: healthy people, healthy animals and healthy plants within a healthy environment. National action plans are the pillars of the global approach launched by the WHO in 2015 and the current 'European One Health Action Plan against Antimicrobial Resistance' in the fight against AMR. They are important tools to take steps forward nationally and internationally.'

Important building blocks for AMR resolution

To underline the importance of AMR once again, later this year (Sept 2024) the United Nations General Assembly (UNGA) will hold a meeting to discuss the current threat of antimicrobial resistance. Ahead of that, The Lancet is publishing a series of four articles that exhaustively address the issue. The articles present crucial data, evidence and policy recommendations, which serve as important building blocks for shaping a UN resolution on AMR. From the Netherlands

Heiman Wertheim, head of department and professor of medical microbiology at Radboudumc since 2015, co-authored one of the articles.

Clear goals and political support

Wertheim: "In the series, we outline the current disease burden of AMR, and that it makes sense to get politicians on board with clear, global goals." Utility and necessity are summarized succinctly once again by the editors of The Lancet: "If the world does not prioritize action against AMR now, we will see a steady increase in the number of deaths worldwide - currently 4.95 million per year from AMR-related infections - with young children, the elderly and people with chronic diseases or who need surgical procedures at greatest risk. Improving and expanding existing methods of infection prevention, such as hand hygiene, access to diagnostics, regular cleaning and sterilization of equipment in health facilities, availability of safe drinking water, effective sanitation, and use of childhood vaccines, could prevent more than 750,000 AMR-related deaths annually in low- and middle-income countries (LMICs).

Diagnostics, vaccines, new antibiotics

With fellow authors, Wertheim highlights the development and availability of antibiotics, vaccines and diagnostics. "New antibiotics are urgently needed," says Wertheim, "but don't forget a large part of the world's population still doesn’t have access to existing antibiotics anyway because of excessively high prices, failing healthcare systems and other factors. There is an awful lot of room for improvement there." Wertheim also stresses the great importance of availability of diagnostics and (new) vaccines for both bacterial and viral infectious diseases. "Not only to prevent those diseases," he says, "but indirectly, a lower disease burden through vaccination also reduces the use of antibiotics. As a result, you reduce the chances of developing resistance." In The Lancet article, Wertheim and his colleagues also highlight the crucial role of a correct diagnosis. "The diagnosis determines which drugs are used. Without affordable, reliable and rapid diagnoses, available to everyone everywhere, the risk of incorrect antibiotic use increases. And with it, the likelihood of resistance development."

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Find The Lancet series Sustainable Access to Antibiotics here

To discuss the impact of AMR, the importance of access to antibiotics and the pursuit of global goals, the articles will be discussed at a symposium with authors, experts, policymakers and civil society organizations. The event will take place on May 28 (6:30 PM - 8:30 PM (GMT+2, Geneva, Switzerland)) and can be followed via a Livestream.

Register at: https://www.eventcreate.com/e/amrlancetserieslaunchlivestream

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