UK Falling Short on Antimicrobial Resistance Targets

The United Kingdom government recognises antimicrobial resistance (AMR) as a serious threat, but progress in tackling it has been limited, according to a report from the National Audit Office (NAO). 

The report found that only one of five key targets to contain AMR has been met, despite the growing threat of drug-resistant infections.

The independent public spending watchdog examined the government’s response in light of the “serious public health threat” from AMR, and because the UK’s response to the COVID-19 pandemic showed the country was “not as resilient to such threats as it expected to be”.

In addition, it was “proving hard to shift the behaviours of millions of citizens and thousands of institutions” the report authors noted. “AMR is a serious threat globally and to the UK and, if not addressed, the consequences for health, life expectancy, the functioning of the NHS, and the wider economy will be huge,” they warned.

The NAO’s Comptroller and Auditor General, Gareth Davies, said in a statement that despite the government’s response, ” the results have been limited, and the country needs to become more resilient to this long-term risk”.

Commenting for Medscape News UK, Dr Colin Brown, deputy director of the UK Health Security Agency, said: “We know that the rise in antimicrobial resistance continues to be a global challenge we need to meet. There is a long way to go, and everyone has a role to play.”

Rising Drug-Resistant Infections

AMR is directly responsible for 7600 deaths in the UK each year and contributes to around 35,200 annual deaths, according to the NAO report. The World Health Organization has long identified AMR as one of the top global public health threats. 

The UK’s 5-year action plan for microbial resistance (2019-2024) aimed to halve healthcare-associated Gram-negative blood stream infections, reduce human antimicrobial use by 15%, and ensure prescriptions are supported by diagnostic tests. However, only one target – reducing antibiotic use in food-producing animals – has been met.

Instead of cutting specific drug-resistant infections by 10% by 2025, the report found these infections have risen by 13% since 2018.

Impact of COVID-19 and NHS Challenges

The report noted that the COVID-19 pandemic and demographic changes have complicated efforts to combat AMR. Patients are arriving at hospitals with more pre-existing conditions and staying longer, increasing the risk of infections. 

The deteriorating condition of NHS facilities was another concern. Some hospitals and healthcare settings struggle to meet modern infection control standards, making it harder to contain the spread of resistant bacteria. While the pandemic prompted healthcare organisations to “tighten their infection prevention and control standards”, overstretched staff delivering “oversubscribed” services may have struggled to implement them consistently, the authors observed.

The report also highlighted limited public awareness of AMR. In 2018, only 49% of people in the UK knew that antibiotics do not work against viruses. There was also “limited evidence” for the impact of public awareness campaigns.

Brown emphasised that “important progress” had been made in recent years, which included developing surveillance to track and integrate antimicrobial usage and resistance data. “We are also continually testing different therapeutic approaches to treat multidrug resistant organisms and researching ways to improve prescribing practices,” he said.

Grave Threat to Human Life

The next AMR National Action Plan (2024-2029) sets more achievable targets than its predecessor. However, the report highlighted that it was unclear whether meeting these would reduce the burden of AMR in the UK. “Government needs to consider whether its existing commitments and other efforts across the public sector will be enough to achieve its 20-year vision to contain and control AMR,” Davies said.

Poor practices across the world, including in the UK, “have worsened the problem” of antimicrobial resistance (AMR), said the report, which warned that there were “huge foreseeable consequences for the world, including UK citizens, if humanity fails to address increasing resistance”.

“The world needs to take the problem of antimicrobial resistance seriously, and the UK government must lead by example,” urged Sir Geoffrey Clifton-Brown, chair of the Commons Public Accounts Committee, in a statement.

“In the shadow of COVID-19, this silent pandemic deserves equal attention to safeguard public health and the NHS,” he stressed. “Unless measurable change to reduce the spread of antimicrobial resistance is achieved, there remains a grave threat to human life and society as we know it.”

Dr Rob Hicks is a retired NHS doctor. A well-known TV and radio broadcaster, he has written three books and has regularly contributed to national newspapers, magazines, and online. He is based in the UK.