24th May 2024

The Lancet has today published a new series on antimicrobial resistance and the need for sustainable access to effective antibiotics, written by BSAC Garrod medallist Ramanan Laxminarayan and colleagues. BSAC President, Professor Andrew Seaton, explains why the Society welcomes this series and supports its recommendations, while pointing to the need for assurances that the core principles of antimicrobial stewardship are promoted and maintained.

Drug resistant infections due to antimicrobial resistance (AMR) are a real and growing global threat with the burden falling most heavily in regions with least developed healthcare infrastructure. AMR however cannot be considered as an isolated phenomenon. Morbidity and mortality due to infections which will respond to prompt administration of first line or Access antimicrobials predominate globally, including in low-income and middle-income countries (LMICs). Solutions to AMR require broad solutions to prevention and treatment of all infection and involve a whole system approach. In this excellent Lancet series BSAC Garrod medallist Ramanan Laxminarayan and colleagues outline the critical importance of prevention, through access to water, sanitation, hygiene and vaccination, as well as assuring availability of key diagnostics to guide therapy and Access antimicrobials to treat. Language is important whether communicating with policy makers or those delivering care. Aligning the challenges and breadth of impact of infection and AMR with Sustainable Development Goals is particularly important when considering communication at policy level. In this sense antimicrobials should be regarded as critical infrastructure to support and grow a properly functioning society and economy.

The UN General Assembly (UNGA) high-level meeting on AMR in September 2024 is a critical opportunity for global action. Ambitious global targets for 2030 are proposed within this Lancet series including a 10% reduction in mortality from AMR; a 20% reduction in inappropriate human antibiotic use; and a 30% reduction in inappropriate animal antibiotic use. To achieve these goals coordinated global commitment, consensus of actions and accountability is required. Fundamental to success will be support for action and leadership from LMICs.

BSAC welcomes this Lancet series and supports the recommendations made. For sustainable access to effective antibiotics the Society would like to emphasise the importance of local and national Antimicrobial Stewardship programmes ideally incorporated into National AMR Action Plans. Recognising the challenges of delivering equitable and timely assessment and treatment the Society supports enabling wider cohorts of healthcare workers including (but not limited to) nurses and pharmacists to prescribe or provide antimicrobials in a regulated framework and underpinned by appropriate training, education and surveillance of practice. With widening of access there is a need for assurances that the core principles of antimicrobial stewardship are promoted and maintained.

Read The Lancet Series on Antimicrobial Resistance: The need for sustainable access to effective antibiotics

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