A team of experts from The University of Manchester has issued a pressing call for urgent global measures to combat drug-resistant infections, warning that these infections are anticipated to surpass cancer in terms of casualties over the next 25 years.

In an article released by the University’s policy engagement unit, Policy@Manchester, Dr Michael Bottery, Professor Michael Brockhurst, Professor Lucie Byrne-Davis, Professor Michael Bromley, and Dr Wendy Thompson highlight the escalating levels of antimicrobial resistance (AMR). They emphasize that this phenomenon is diminishing the effectiveness of frontline medications used to treat bacterial, viral, fungal, and protozoal infections, including malaria.

The authors outline several factors contributing to the emergence of AMR, including the widespread use of antibiotics and antifungals in agriculture, a disjointed regulatory approach to antimicrobials, and a concerning 25% surge in antibiotic prescriptions by dentists during the pandemic.

“COVID-19 sharply demonstrated that diseases are not limited to a single nation and tackling antimicrobial resistance requires global cooperation,” they write. “As a start, international bodies like the UN, WHO and the EU should provide detailed guidance on the use of antimicrobials in agriculture. This should include risk assessments on the likelihood of cross-resistance evolving because of the dual use of the same types of antimicrobials across agriculture and the clinic.”

Calling for rigorous regulation, the academics assert, “Before a new antimicrobial is permitted for commercial use, independent assessment must be conducted on its potential impact on clinical use.” They suggest that collaboration between the Environment Agency, the Medicines and Healthcare Products Regulatory Agency (MHRA), and the UK Health Security Agency is essential, advocating the establishment of a cross-agency working group to facilitate this process in the UK.

Drawing from their research, the team explains that the spike in antibiotic prescriptions in dentistry was influenced by systemic factors, leaving dentists frustrated about their inability to provide safe and effective care in line with clinical guidelines. They recommend that future targets for optimizing antibiotic prescribing should be at the system (commissioner) level, focusing on improving access to safe and effective care for individuals with acute dental problems.

In shaping the UK’s future AMR strategy, the authors urge reliance on research from The University of Manchester and other institutions to identify new ways to conserve the effectiveness of antimicrobials for future generations. They propose aligning research goals with the UK’s national AMR action plan and the WHO’s Global Action Plan on AMR, particularly through global health research and education activities in low and middle-income countries.

The experts conclude, “Antimicrobial resistance is an existential threat, intimately entwined with the risks posed by climate change and overconsumption. Like the climate crisis and resource scarcity, the solution lies in a mix of new innovations and smarter guarding of current assets.”

The article, titled ‘Culture Shift: Tackling Antimicrobial Resistance from Agriculture to Operating Table,’ authored by Dr Michael Bottery, Professor Michael Brockhurst, Professor Lucie Byrne-Davis, Professor Michael Bromley, and Dr Wendy Thompson, can be accessed on the Policy@Manchester website.