UK Announces Next Phase in Combating Antimicrobial Resistance

The recently announced 2024 to 2025 UK national action plan (NAP)¹ to address antimicrobial resistance (AMR) is the second 5-year phase of a 20-year strategy announced in 2019, building on initiatives in the first phase that include reducing antibiotics in food-producing animals, improving antimicrobial utilization surveillance systems, and piloting new payment schemes to support development of effective antibiotics. "AMR is a pervasive threat," the UK plan declares."The emergence of infections is relentless, while the pipeline for new antibiotics has run dry.Through this national action plan, we set out the challenge to the UK and to other counties to continue our excellent work to confront AMR, to preserve and develop these essential medicines for generations to come, and help us address one of the most pressing challenges we face this century."

The UK NAP arose several years after the US action plan² commenced in 2013, but shares major objectives as well as the organization into 5-year phases to facilitate updating priorities, and taking stock of progress and obstacles.The objectives described inthe US plan are: responding to new and going antimicrobial threats; strengthening detection of AMR; slowing emergence and spread of AMR; improving antibiotic and antifungal use; advancing development of rapid diagnostics for antimicrobial-resistant pathogens; enhancing infection control measures to prevent resistant infections; and accelerating research on new antibiotics, antifungals, and other therapeutics and vaccines.

The 2024-2029 UK NAP organizes 9 strategic outcomes under 4 themes. Within the theme of reducing the need for, and unintentional exposure to antimicrobials, strategic outcomes are to: implement a range of infection prevention and control management programs for humans, animals, agriculture and the environment; educate and engage the public; and strengthen surveillance.

In the theme of optimizing use of antimicrobials, the two outcomes are: improved antimicrobial stewardship and disposal; and building a well functioning AMR workforce in human and animal health and in agriculture.

In the theme of investing in innovation, supply and access, the three outcomes are: "Innovation and influence" to call on life sciences sector to prioritize these developments; to make information actionable, through encouraging application of robust surveillance and scientific research and data into decision making; and to address health disparities and inequalities.

The fourth theme is for the UK to be a good global partner, with the final strategic outcome of practicing "AMR diplomacy" by confronting AMR as a worldwide problem that requires global action.

The NAP authors acknowledge that resources are finite, and so indicate that the plan was designed using a risk-based approach, targeting interventions where the evidence for impact was strongest.

"This approach includes supporting the necessary research to address the gaps where there is little evidence about which interventions work.This approach will have the highest impact and represents the best value for money," they indicate.

The authors also concede that providing information about the problem does not directly lead to behavior change, but suggest "it's an important first step."

"Improving knowledge of both the public and healthcare workers may lead to improvements in antibiotic prescribing and consumption," they conclude.

References

1.Department of Health & Social Care and Department for Environment Food & Rural Affairs, UK Government, Department of Agriculture, Environment and Rural Affairs and Department of Health, Northern Ireland, and Departments of the Scottish and Welsh Governments.Confronting Antimicrobial Resistance 2024 to 2929.Updated May 8, 2024. https://www.gov.uk/government/publications/uk-5-year-action-plan-for-antimicrobial-resistance-2024-to-2029/confronting-antimicrobial-resistance-2024-to-2029.Accessed May 21, 2024.

2.US Department of Health and Human Services, US Department of Agriculture, US Department of Defense. National Action Plan for Combating Antibiotic-Resistant Bacteria, 2020-2025.October 8, 2020.https://aspe.hhs.gov/reports/national-action-plan-combating-antibiotic-resistant-bacteria-2020-2025. Accessed May 21, 2024.