Tackling antimicrobial resistance

It’s 1945, and Alexander Fleming is giving his Nobel Lecture. He tells the story of the accidental discovery of penicillin with humbleness and poise, and just before handing over to Sir Howard Florey with whom he shared the prize, he utters words which have come to hold a particular poignancy.   “There is the danger”, he said, “that the ignorant man may easily underdose himself and by exposing his microbes to non-lethal quantities of the drug make them resistant.” He had, a mere two years after the drug had become widespread, outlined the problem of antimicrobial resistance. Two years after his warning the first case in a patent was noted. The drug, of course, went on to change the course of our history and it is this very success – and the success of the antibiotics that followed – that distracted many from the inherent problems with its use. We became addicted to antibiotics, and threw consequence to the wind - the elixir of antibiotics proving too strong a pull. Not just medically, but agriculturally and industrially as well. And so while antimicrobial resistance has been well known for over 60 years, the world has been very slow to react. With the broad use of antibiotics we have altered the very environment in which microbial life exists. And as we pile on the selective pressure, the fire in the evolutionary forge – stoked by our own pharmaceutical advancement – burns ever hotter. The result: an increasingly ‘smart’ microbial army. But at last, recognition of the resistance problem is being matched by action…of a sort. The Government has released their five year antimicrobial resistance strategy, and whilst being widely welcomed by the scientific community, there are some serious concerns over its application. On page 20 we delve into the plan to find out exactly what it is that is proposed.

While antimicrobial resistance has been well known for over 60 years, the world has been very slow to react

So we are fast approaching a vital juncture in the history of antibiotics as we know them. Can we find a new avenue of weakness for our biological foes, or are we approaching the end of a halcyon period? Humans…we are capable of truly staggering feats of ingenuity. Yet we can be frustratingly inept, even in the face of looming catastrophe. Be it a humanitarian crisis to which we are slow to react, or an environmental disaster which receives little more than our chin-scratching concern. Undeniably, there are times when we need grabbing firmly by the shoulders and shaken into action. The question is: will this new antimicrobial resistance strategy be such a shake? Can we turn numerous steering group recommendations and strategies into real results – or as the numerous researchers, regulators, policy makers and medical professionals involved battle to have their say, will we literally suffer death by committee?