By 2050 antibiotic resistance could claim more lives than Cancer: IMF Panel

Contributed by Siddarth D & Dr. Tamhankar

 

Last week at the IMF meeting in Washington, UK Chancellor George Osborne stated that 10 million people a year could die across the world by 2050. This was more than the number of people dying due to cancer each year. The Chancellor also warned of the economic cost of resistance which could cut global GDP by 3.5%, a cumulative cost of $100bn (£70bn). Thus, unless global action is taken, antimicrobial resistance will become an even greater threat than cancer currently is.

The panel which is part of the IMF's Annual Spring Meeting is being held in Washington DC and is looking at emerging economic concerns that could arise in the future. WHO representatives would also be attending the meeting to put forward health concerns that could result in economic challenges.

While there is recognition of the health impact of antibiotic resistance, the human costs and economic costs are seldom discussed. Given that pharmaceutical companies, drug manufacturers and the markets play a critical role in shaping healthcare outcomes and policies for antibiotic use, it is critical that bodies like the IMF are aware and act on health concerns due to antibiotic resistance. Without policies and incentives to regulate the drug market, the battle against antibiotic resistance would certainly be impossible to win.  

Awareness and incentives reduce prescribing of antibiotics in UK

Contributed by Siddarth D & Dr. Tamhankar 

 

Over 2 million fewer antibiotic prescriptions were dispensed in primary care throughout 2015 compared to the year before, according to data from NHS (National Health Service) in the UK. This was 7.9% reduction was attributed the incentives introduced to general physicians as well as extensive campaigns to build awareness on antibiotic resistance. 

The NHS along with the Public Health England Department had initiated these campaigns with emphasis in hospitals on vaccinations, general hygiene practices and judicious prescribing of antibiotics. Healthcare facilities and healthcare providers  following these recommendations and demonstrating fall in antibiotic prescribing and consumption were given financial incentives through the campaigns. Given that safely reducing the amount of antibiotics prescribed to patients was an important part of work to tackle antimicrobial resistance, the  NHS and the PHE had started series of campaigns to reduce prescription of antibiotics. It was based on the fact that inappropriate use and overuse of antibiotics were known drivers of resistance, so reducing the amount of antibiotics consumed slowed bacteria developing resistance to these vital drugs and therefore helped prevent antibiotic-resistant infections. 

The NHS officials have lauded these results and promised to do more to tackle the menace of antibiotic resistance. This a good impetus for other countries to follow, by taking up initiatives involving the healthcare system itself to achieve substantial results in curbing antibiotic resistance.

India creates fund for enabling research on tests for antibiotic resistance

Contributed by Siddarth David & Dr. Tamhankar

The Department of Biotechnology (DBT) of the Government of India has created a fund of  $1,00,000 to start India focussed research on antibiotic resistance for biotechnology start-ups in India.  The fund will be given through the Biotechnology Industry Research Assistance Council (BIRAC) for the start-ups to compete for prestigious Longitude Prize which is £ 10 million prize offered by Nesta, a U.K. charity, to any individual group anywhere in the world that develops an affordable, effective diagnostic test to detect resistance to micro-organisms.

Renu Swarup, Managing Director, BIRAC, said the collaborations were to encourage more biotechnology start-ups in India as well as creating an atmosphere where innovation is encouraged and nurtured. BIRAC is a not-for-profit Public Sector Undertaking, set up by DBT as an interface agency to support emerging biotech enterprises to undertake strategic research and innovation, to address nationally relevant product development needs. BIRAC has supported nearly 300 start-ups and Small and Medium Enterprises (SME) and 170 young entrepreneurs for innovation, research and product development.

Given the critical health challenge posed by antibiotic resistance in India, this is a welcome move to encourage research and develop context-specific solutions.

India issues guidelines for checking hospital infections

Contributed by Dr. Tamhankar & Siddarth David

 

In a move aimed at controlling hospital acquired infection, the Ministry of Health and Family Welfare issued guidelines for healthcare institutions in India to prevent transmission of infections. The guidelines were developed by the Indian Council of Medical Research (ICMR), covers the basic principles of infection control, role of health care workers, bio-waste management and elaborates on the steps to be followed for setting up of an effective infection control in hospitals. The norms also include measures for judicious use of antibiotic in hospitals. 

This comes close to the heel of the International Conference on Antimicrobial Resistance held by the Ministry of Health and Family Welfare, India and the World Health Organization (WHO) Regional Office for South Asia last week in New Delhi. The event stressed need for all the countries in the region to adopt strategies to combat antimicrobial resistance. 

Such guidelines were needed in India to ensure that indiscriminate use of antibiotics is not the solution for preventing hospital-acquired infections. Once enforced, the new guidelines can play a major role in curbing the use of antibiotic in hospitals and promoting alternate methods to control infections.

Vaccines could aid in the fight against antimicrobial resistance

Contributed by Dr. Tamhankar & Siddarth David

 

The latest report from the Review on Antimicrobial Resistance (AMR) says that improved utilization of existing vaccines could reduce the use of antibiotics and consequently antimicrobial resistance. The report points out that if vaccination coverage was improved it could be a critical step in reducing antimicrobial dependence for infectious diseases.

The report says that the nearly 800,000 deaths due to bacterial Pneumonia could be reduced as well as nearly 11.4million days of antimicrobial could be reduced by providing universal pneumococcal vaccination. While discussing the significance of the findings, the report says " Tackling antimicrobial resistance requires a wide range of approaches and developing alternatives to antibiotics, in humans and animals, is critical to the fight. Vaccines have a vital role to play in combating drug resistance, by preventing infections in the first place."

The AMR Review was commissioned by the UK Prime Minister and is hosted by the Wellcome Trust to recommend series of measures to deal with the challenge of antibiotic resistance. However, widely effective the vaccine approach maybe it is clear that using the existing methods to address antimicrobial infections such as hand washing, etc. maybe the way ahead in antimicrobial resistance. The report is therefore another reinforcement that the solutions to the problem of antibiotic resistance may very well be there with us. In India where we still have yet to achieve universal coverage for immunization this could be another reason to accelerate the process as we have an emerging public health burden related to antibiotic resistance in the country.

New Toolkit developed for monitoring antibiotic resistance especially among physicians and nurses

Contributed by Siddarth David & Dr. Tamhankar

The Royal College of Nursing in the UK, last week launched a infection control and antibiotic resistance management toolkit. It especially looks at sepsis in two main causes of infections in hospitals pneumonia and urinary tract infections.

The toolkit seeks to highlight organisational approaches to infection  prevention and control across primary, secondary and social healthcare settings. It also provides guidelines to address the hospital acquired infections in the health facility especially at the level of nurses and general physicians. It also lays down indicators to evaluate the steps taken to reduce hospital infection rates and antibiotic use.

The toolkit though not mandatory is the way forward in addressing antibiotic resistance. It can be easily replicated with appropriate contextualization in other national and regional settings.  

Pharmaceutical Companies Sign Declaration to Act Against Antibiotics

Contributed by Siddarth D & Dr. Tamhankar

In a first of its kind step, drug makers have pledged  joined hands with governments and other bodies working on addressing the problem of antibiotic resistance. Declaration on Combating Antimicrobial Resistance was signed by 85 phrama, bio-tech and drug companies including GlaxoSmithKline, Johnson & Johnson, Novartis and Pfizer as well as Cipla from India, to adhere to a common set of protocols keeping in mind antibiotic conservation.

The declaration was launched as part of the World Economic Forum in Davos, Switzerland, and outlines several key measures the government and industry must take to increase antibiotic effectiveness worldwide. This was done in collaboration the Review on Antimicrobial Resistance, a group commissioned by the UK Prime Minister for the purpose of raising awareness for the economic issues surrounding antimicrobial resistance (AMR).

This 21st January declaration, has broadened the scope of involving all the stakeholders in the process of tackling antibiotic resistance. Drug companies have been criticised for not doing enough to control the market forces that impeded unregulated production and sale of antibiotics. Rather than working in silos, it is only when policy makers, field workers, researchers and drug companies are on the same page, that effective steps can be taken to rationalize the use of antibiotics.  It is hoped that more drug makers sign the declaration and are part of the solution rather than the problem to antibiotic resistance.

Gene that makes superbugs found in Canada

Contributed by Siddarth D & Dr. Tamhankar

The MCR-1 gene that makes E. coli and some other species of bacteria resistant to colistin, an antibiotic considered the drug of last resort for infectious diseases has been found by scientists in samples in Canada. Moreover, the MCR-1 gene was found on a free-floating  bit of DNA: the plasmid allowing it to be transferred easily to other micro-organisms.

Public Health Agency of Canada's National Microbiology Laboratory had launched a nation-wide campaign to test samples for the presence of antimicrobial resistance. The three cases in Canada were reported in Canadian woman returning from Egypt and two from beef samples in Ottawa. This adds to the confirmed cases of the presence of the MCR-1 gene which was first reported in China and shared in this blog. Since then, scientists in other countries, including Britain, Denmark and Laos, have had similar findings.

This finding has reiterated the need to address the phenomenon of antimicrobial resistance at the global level with better stewardship and appropriate use.