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by GK Strategy 23rd October, 2018
3 min read

Five questions raised by antimicrobial resistance report

Led by Dr Sarah Wollaston, the Health and Social Care Committee is respected across Parliament for not shying away from asking difficult questions or making challenging recommendations. Launching an inquiry into antimicrobial resistance (AMR) attests to that.

Such an inquiry provided a critical opportunity to set priorities for the renewal of the Government’s 5-year AMR strategy and to drive progress with evidence-based recommendations.

On Monday 22nd October the Committee published the resulting report. But the recommendations, and the inquiry process itself, have raised more questions than they have answered. Below, we’ve set out 5 questions that have gone unsettled.

  1. Was the inquiry process as thorough as the subject matter required it to be?

The threat of AMR is profound and preventing its spread is a challenge that will require cooperation, nationally and internationally, between governments and industry, and between patients and providers. Indeed, the report opens by saying “modern medicine will be lost” without action to address the threat.

So why then, given the importance the committee itself attributed to the matter, was the entire report written within five weeks of the deadline for written evidence, and just four weeks after oral evidence was given?

Why also, save the Association of the British Pharmaceutical Industry (ABPI), was industry not invited to give oral evidence? Industry voices are critical in the formulation of any government policy, especially one of this magnitude. The government has missed an opportunity to hear new ideas about how to tackle AMR as a result.

  1. What should a dedicated budget for antimicrobial resistance consist of?

The report calls for the Government to provide a dedicated budget for tackling antimicrobial resistance. It does not, however, provide much indication of how this budget should be curated, nor how it should be allocated.

Dr Susan Hopkins, a Deputy Director at Public Health England, said “funding could always be greater across all the areas.” Unfortunately, if the Government cannot see which areas within AMR are most in need, then it won’t be able to see the potential rewards of its investment.

What will provide the best value from a Government perspective: Investment in funding for drug development? Prevention? Clinician education? Food, trade and the environment? What level of funding will provide the real progress that this report demands? And how much should be provided by whom?

  1. Prevention, what prevention?

“Prevention is key”, or so the report says. But instead of looking at all the ways in which the spread of AMR can be reduced, such as through hand hygiene and vaccination, the report has a narrow focus, looking only at the use of antimicrobialsIt centres on antibiotic prescribing, for which there are four recommendations, but misses out other important parts of the puzzle.

  1. What should the Government do beyond injecting more cash?

The report called for a renewal in political leadership, urging the Prime Minister to establish AMR as one of the Government’s “top 5 priority policy areas”. To call for political leadership on AMR necessitates that the investment of resources will provide a return. It’s one thing to recognise AMR as a challenge, but politicians need solutions to take to the public if they are going to speak out on this issue.

Instead of calling for more political noise on AMR, at this stage in development, this report provided an opportunity to give the Prime Minister a reason to prioritise it. Instead it sets out just a few vague ideas, for example it’s proposals on digital health, that do not go far enough in their scope or description.

  1. Where does the 5-year AMR Strategy feature in all this?

The Government’s renewed 5-year strategy on antimicrobial resistance is due for publication in the new year. This report, therefore, was the perfect opportunity for the Committee, and the experts who gave evidence, to reflect on the progress and shortcomings of the previous AMR strategy and to look forward to what can be done to improve it. Unfortunately, the report only references the upcoming renewal of the strategy just a handful of times.

Antimicrobial resistance is a vast, complex and interconnected policy area – launching a meaningful inquiry was always going to be a challenge. With the Government’s AMR strategy originally due to be published in November, it is hard not to see the short timelines and narrow focus of this inquiry as efforts to meet that November deadline. But as the report itself now states, the publication of the AMR strategy is now delayed until 2019, which makes this inquiry feel like a missed opportunity.

Notes

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