Antimicrobial resistance

Antimicrobial resistance (AMR) is a significant and increasing threat to public health globally. It is estimated that in the US and Europe alone, antimicrobial-resistant infections currently cause at least 50,000 deaths per year with hundreds of thousands more dying in other areas of the world.

If we are unable to slow the acceleration of AMR, future consequences could be worse still.   It has been estimated that 10 million people a year could be dying as a result of AMR by 2050.^[1]  The Chief Medical Officer, Professor Dame Sally Davis has said that if we do not act, it is possible we will return to a time where 40 per cent of the population die prematurely from infections we cannot treat.^[2]

There is action that can be taken to slow the progression of AMR. Examples of these include:

• Improving infection control;
• Ensuring appropriate prescribing and use of antibiotics in both humans and animals;
• Investing in research and development (R&D) for new drugs and diagnostic tools; and
• Ensuring adequate monitoring of prescribing and resistance on a national and international basis.

The independent review on antimicrobial resistance (the AMR review) was launched by the former Prime Minister, David Cameron in July 2014 and was led by the economist Lord O’Neill of Gatley.^[3]  The 2016 final report made ten recommendations, these included better surveillance of antimicrobial use and resistance, a global public awareness campaign, and the introduction of new approaches to funding medicine and diagnostics development.  The Government response agreed with a need for improved investment in R&D, and said it would work to gain global support for the recommendations in the report.

Much of the work in the UK is within the multi stranded UK AMR Strategy 2013-18. A 2016 review of this strategy reported that progress has been made putting in place the building blocks for success, and early signs suggested good results with some initiatives but that there is yet to be unequivocal evidence that these measures are making a difference.   The UK Government has also played a significant role in international work on AMR.

Surveillance figures on UK antimicrobial resistance levels and prescribing were published in October 2017. These show that for all infections the percentage of cases involving antibiotic resistance was higher in 2016 than 2012.  However, the report set out that antibiotic use had reduced by 5% between 2012 and 2016  and in the same period, the number of prescriptions dispensed in primary care had decreased by 13%.

International work on antimicrobial resistance is led and coordinated by the World Health Organisation. A Global action plan on AMR was published in 2015, and the WHO also provides guidance for countries on the development of national action plans, and conduct international surveillance on AMR.  Despite international commitment to address AMR, concerns have been expressed recently that action has been slow.

This briefing paper aims to provide an overview on antimicrobial resistance, its causes, and consequences. It provides a summary of some UK and international action in this area. 

[1]     The Review on Antimicrobial Resistance, Antimicrobial Resistance: Tackling a crisis for the health and wealth of nations,

[2]     Kings Fund, What if antibiotics were to stop working? (accessed 14 November 2017)

[3]     Department of Health and Prime Minister’s Office, Prime Minister warns of global threat of antibiotic resistance, 2 July 2014