We talked to key members of the World AMR Congress about the latest efforts to sustain the efficacy of antimicrobials and what people can do to reduce the spread of AMR.
Malin Grape
Ambassador on Antimicrobial Resistance, Ministry of Health & Social Affairs
“To be successful, we need to be able to make progress on many fronts at the same time.”
Why is it important for stakeholders all across the globe to do their part in the fight against AMR?
We are all at risk of untreatable infections — AMR has a direct impact on people’s lives. If we can’t rely on effective medicines to prevent and treat infections, not only will it affect health systems, but also our food safety and security, and our sustainable economic development will be undermined. Already we can see that the most vulnerable people are the ones suffering the most, with one-fifth of the 5 million annual deaths associated with resistance to antibiotics being in children under the age of 5.
What methodologies, practices, and tools are the most effective for slowing AMR?
To be successful, we need to be able to make progress on many fronts at the same time. We need new and innovative treatments, and reliable access to medicines when they are needed. At the same time, we need substantial reduction of the inappropriate use of existing antibiotics, and we need to prevent the spread of infections and resistant bacteria.
Important tools to reach these overarching goals are, for example, rapid and affordable diagnostics, surveillance of both resistance and use of antimicrobials, as well as new incentives to stimulate research and development, and awareness-raising in all sectors of the society.
What can the average person do to help stop AMR?
I think we can all do something to contribute. We can all help by talking more about AMR, which is essentially an ongoing pandemic, and spread knowledge and awareness among our family members, friends, and colleagues. We are in this situation because of human behavior —the overuse and misuse of antimicrobials over decades has led us to where we are today and since we are all affected, we can also all play a role in turning the tide of the continually increasing resistance.
Is there anything we can/should be doing better or differently to reduce the risk of AMR?
I would say there is a lot we need to do better and to do more of. The main change needed in my opinion is much stronger collaboration between countries, stakeholders, and sectors. If we regard untreatable resistant infections as the threat to global sustainable development that they are, it becomes obvious that this work requires much more engagement and commitment than we are seeing today.
John Jernigan
Chief, Epidemiology Research and Innovations Branch, Centers for Disease Control and Prevention (CDC)
“The most foundational and successful tool we have to combat AR is stopping infections from happening in the first place — we know prevention works
Why is it important for stakeholders across the globe to do their part in the fight against AMR?
A resistant threat anywhere can quickly become a global threat everywhere. Antimicrobial resistance (AR) is an urgent global public health threat, estimated to have killed at least 1.27 million people in 2019. Germs will inevitably find ways to resist antibiotic and antifungal drugs, which is why aggressive action is needed now to stop new resistance from developing, and to prevent the resistance that already exists from spreading.
Germs can spread within healthcare facilities, communities, our food supply, and the environment. Modern travel of people, animals, and goods means resistance can easily spread. One billion people cross through international borders each year. This includes 350 million travelers arriving in the United States through more than 300 points of entry.
The capacity and resources for infection prevention and control vary worldwide. When infection prevention and control capacity is strengthened in a country, the world benefits. CDC works with partners across the globe on efforts to protect people from the threat of AR, including:
- Improving quality and consistency of infection control.
- Detecting and responding to resistance early, containing it before it becomes common.
- Enhancing and developing products that improve hygiene, prevent infections, and keep germs from spreading.
- Increasing education and awareness around AR and infection prevention and control.
What methodologies, practices, and tools are the most effective for slowing AMR?
The most foundational and successful tool we have to combat AR is stopping infections from happening in the first place. We know prevention works; CDC reported in 2019 that dedicated infection prevention and control efforts drove down deaths from antimicrobial-resistant infections by 18% overall and by nearly 30% in hospitals from 2012 through 2017 in the United States.
Some of this progress was erased during the pandemic, as healthcare facilities, health departments, and communities were pushed near their breaking points. A 2022 CDC report found a significant increase in antibiotic use as well as a difficulty in following infection prevention and control guidance, resulted in an increase in healthcare-associated, antimicrobial-resistant infections in U.S. hospitals in 2020 and 2021.
Setbacks for AR can and must be temporary. The COVID-19 pandemic has made it clear —prevention is preparedness. The nation must invest in prevention to be better prepared for future threats, regain lost ground on this public health threat, and save lives.
Improving antibiotic and antifungal use is also a key strategy to slow the development of resistance. These drugs are a shared resource, meaning that using antibiotics for one purpose or patient can impact how they work for another. We must be responsible stewards of these drugs, no matter where they are used, to prolong and preserve their efficacy and protect patients of today and tomorrow.
Another critical tool is investing in rapid detection and containment to stop the spread of AR. These investments include CDC’s Antimicrobial Resistance Laboratory Network, which works in
the United States, and CDC’s Global Antimicrobial Resistance Laboratory & Response Network. With the help of our partners, both lab networks have been able to rapidly detect AR threats inside and outside of the country, and help to inform strategies to stop spread, and protect people and communities.
What can the average person do to help stop AMR?
No one can completely avoid getting an infection, but there are steps you can take to reduce your risk and help stop the spread of germs.
- Keep your hands clean. It is one of the best ways to prevent infections, avoid getting sick, and prevent spreading germs. Soap and water or hand sanitizers do a great job.
- Keep cuts covered and clean until they are healed.
- Stay up to date on recommended vaccines. Vaccines help prevent infections, slow resistance, and reduce the need for antibiotics and antifungals.
- Cover your coughs and sneezes to prevent the spread of respiratory infections.
- Prepare food safely to prevent foodborne illnesses. Keep surface areas and utensils clean. Cook foods to safe temperatures and chill leftovers.
- Prevent sexually transmitted infections. STIs like gonorrhea have progressively developed resistance to treatments for it. If you or an animal in your care is sick, ask your healthcare provider or veterinarian about the best treatment.
Ultimately, stay informed. Visit CDC’s Antimicrobial Resistance website to stay up to date on the latest information on AR.
Is there anything we can/should be doing better or differently to reduce the risk of AMR?
CDC is leading the public health fight as the United States continues to take a global One Health approach to combat antimicrobial resistance, cultivating partnerships across industries, countries, and settings to protect people from resistance threats.
The 2022 special report, COVID-19: U.S. Impact on Antimicrobial Resistance, showed the country lost progress combating antimicrobial resistance in 2020 due, in large part, to the effects of the pandemic.
The United States must continue to innovate and scale up effective strategies to prevent infections, stop spread, and save lives. To do this, we need to sustain investments in strengthening infection prevention and control everywhere healthcare is provided, as well as improve the use of and access to antibiotics and antifungal medicines worldwide, along with access to safe water and sanitation to prevent resistant germs from spreading.
It is also necessary to fill the innovation gap on new solutions that can enhance current practices, and protect people and animals by:
- Investing in prevention-focused public health actions that we know work, such as accurate laboratory detection, including reliable diagnostics at point of care, rapid response and containment, effective infection prevention and control, and improved antibiotic and antifungal use.
- Better understanding of antimicrobial resistance in the environment and its impact on human and animal health.
- Expanding innovative strategies to combat antimicrobial resistance, including alternatives to antibiotics and antifungals, new vaccines to combat infections that can develop antimicrobial resistance, and novel decolonizing agents to stop the spread of antimicrobial-resistant germs by people who may not know they are carriers.
Jomana Musmar
Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria (PACCARB), U.S. Department of Health and Human Services (HHS)
“Through new policies, we should spur and sustain investment in the pipeline of new antimicrobial drugs, while still encouraging good stewardship practices across the board.”
Why is it important for stakeholders all across the globe to do their part in the fight against AMR?
AMR is a complex health security issue that impacts the health of humans, animals, and the environment. It truly is a One Health issue for everyone and everything around the world, and requires us to work collaboratively to integrate and unify our approach to solving the problem of AMR. As AMR has the potential to affect us all, we all play a role in being good stewards of antimicrobial use and helping others to do so as well.
What methodologies, practices, and tools are the most effective for slowing AMR?
The PACCARB issues reports with recommendations to help slow down the progression of AMR. At a minimum, however, we should all understand how vital this issue is, and how to safely use the antimicrobials that are available to help people fight off bacterial infections.
What can the average person do to help stop AMR?
Thankfully, there are a lot of things you can do to help mitigate AMR. Get vaccinated. Wash your hands. Ask questions when you are prescribed antimicrobials. Make sure you understand your prescription and any side effects. Also, do not share antibiotics. The bottom line is that antimicrobials save lives, but, if not used correctly, can contribute to AMR.
Is there anything we can/should be doing better or differently to reduce the risk of AMR?
A resolution from the PACCARB was issued in 2021 and remains relevant today — through new policies, we should spur and sustain investment in the pipeline of new antimicrobial drugs, while still encouraging good stewardship practices across the board.
James Graham
Managing Director and CEO, Reece Pharmaceuticals
“The fight against AMR is a collective effort from individuals, healthcare professionals, policymakers, and researchers.”
Why is it important for stakeholders across the globe to do their part in the fight against AMR?
Over the years, AMR has continued to rise and become an urgent global public health threat. It is vital that physicians, nurses, and other healthcare professionals do their part in the fight against AMR by developing improved guidelines on how and when antimicrobials should be used when treating bacterial infections.
With the misuse and overuse of antimicrobials, bacteria become resistant and begin to mutate, which could lead to resistant infections and increase the risk of sepsis — the body’s extreme and life-threatening response to infection.
What methodologies, practices, and tools are the most effective for slowing AMR?
With the increase in multidrug-resistant superbugs, expanding the anti-infective arsenal and developing new ways to target resistant pathogens safely without serious, unwanted side effects for patients and without contributing to AMR is critical. In addition, sepsis is an issue closely related to AMR, causes significant morbidity worldwide, and has no specific treatment available.
At Recce, we are developing a new class of broad-spectrum synthetic anti-infectives that can be used against deadly bacterial pathogens, including their superbug forms, without contributing to drug resistance. These synthetic anti-infectives are entirely manmade and designed with purpose, with no pre-formed natural superbugs. Through their novel mechanism of action, Recce’s anti-infectives have the potential to overcome the hypercellular mutation of bacteria — the challenge of all existing antibiotics to date.
What can the average person do to help stop AMR?
As AMR continues to pose a serious threat to the effectiveness of modern medicine, making it harder to treat infections and increasing the risk of complications, the average person can help stop AMR by following a proper hygiene regimen to prevent infections, including washing their hands regularly and staying up to date with vaccinations to assist in eliminating the spread of bacteria and viruses.
In addition, they should use antibiotics responsibly, only when prescribed by a healthcare professional, and complete the full course as directed. By caring for your health and maintaining a healthy lifestyle, a strong immune system can help your body fight off infections more effectively, reducing the overuse and misuse of antibiotics.
Is there anything we can/should be doing better or differently to reduce the risk of AMR?
One of the most essential tactics in helping reduce the risk of AMR is raising awareness about the importance and severity of AMR to help educate others about the consequences of overusing antibiotics. We encourage everyone to back policies and regulations that promote responsible antibiotics use and support research efforts to develop new antibiotics or alternative treatment options to combat AMR.
The fight against AMR is a collective effort from individuals, healthcare professionals, policymakers, and researchers, and every action made is a contribution to the larger goal of preventing the spread of antibiotic-resistant infections.