Comment EDITOR’S COMMENTwith LOUISE FRAMPTON THE CLINICAL SERVICES JOURNAL Editor


Louise Frampton louiseframpton@stepcomms.com


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STEP COMMUNICATIONS ISSN No. 1478-5641


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AMR: making an impact on the frontline of care


While COVID has shifted into the background, attention has returned once again to the threat of antimicrobial resistance (AMR). The GRAM study (Lancet ID) estimated that nearly 5 million deaths were associated with AMR in 2019, including 1.27 million deaths attributable to bacterial AMR. A new report from the World Health Organization has warned that the R&D pipeline for new antibiotics is thin and access to new and existing treatments remains a challenge.


WHO, in partnership with the Global AMR R&D Hub, recently released a report for G7 Finance and Health Ministers detailing progress on incentivising the development of new antibacterial treatments. Substantial progress has been made by G7 countries to support research and development, particularly by increasing investments and creating new incentive mechanisms to stimulate R&D. However, current efforts remain insufficient to address the antibiotic pipeline and access crisis. In particular, efforts to ensure equitable access to antibiotics in low- and middle-income countries that experience the highest burden of AMR, are lacking. The G7 Finance and Health Ministers also state that there is a need to tackle the spread of


AMR across the ‘One Health’ spectrum of human, animal, and environmental health, including through ensuring the appropriate use and stewardship of antibiotics. There have been some welcome efforts, including the establishment of the $1bn AMR Action


Fund, by industry, to help bring four new antibiotics to market by 2030, but there is a lot more to do. The report proposes a set of priority actions to accelerate progress over the next two years. These include working towards relevant commitments and targets for the high-level meeting on AMR at the United Nations General Assembly in 2024; encouraging alignment and targeted action on financing mechanisms to address the antibiotic R&D and access crisis; and bolstering equitable and global access to antibiotics addressing the most urgent public health needs. The statement can be read at: https://tinyurl.com/454cneas The healthcare sector will play a key role, of course, and the topic was high on the agenda at this year’s Infection Prevention and Control conference. The keynote speaker at the conference, held at the National Conference Centre, Birmingham, was Professor Tony Avery OBE, the National clinical director for prescribing. He highlighted the need to tackle the over- prescribing of antibiotics, to improve prescribing processes, promote better training, as well as increase the use of digital prescribing technologies and point of care diagnostic tests to improve antibiotic stewardship. Dr. Kieran Hand, the AMR National pharmacy and prescribing clinical lead, NHS England & NHS Improvement, continued the discussion and described nurses as “the unsung heroes of antimicrobial stewardship.” Esther Taborn, IP&C lead at NHS England, also asserted that nurses of all grades and roles will have a part to play in antimicrobial stewardship (AMS); nursing leadership are in a unique position to place AMS at the centre of all work to improve health outcomes, prevent harm and protect patients. Ultimately, AMR is everyone’s responsibility. However, infection prevention will be central


to preserving our armoury of antibiotics and every healthcare professional can make a difference. One example is a high impact improvement project implemented at the Oxford University Hospitals NHS Foundation Trust, which halved SSI. Led by Giles Bond Smith, a consultant HPB and emergency surgeon, there is a great deal from this example that can be replicated to help drive down rates of SSI across other Trusts. It is a must read (p19) for all those working within the perioperative care pathway and provides a simple but effective care bundle approach that really makes a difference. Sharing knowledge and best practice across the health service must be a priority going forward; giving staff tried and tested tools to reduce HCAIs will be vital in helping to tackle one of the biggest threats facing humanity.


louiseframpton@stepcomms.com Get in touch and give us your views, email me:


June 2023 I www.clinicalservicesjournal.com 5


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