Antimicrobial resistance (AMR) is an existential threat to human health and prosperity. The O’Neill report, commissioned by the UK government and published in 2016, suggests that without action AMR will cause the deaths of 10 million people a year by 2050 and result in an accumulated cost of $100 trillion for the global economy.
The University’s Dame Sally Davies Chair in Antimicrobial Resistance, Professor William Hope explains why and how the Centre of Excellence in Infectious Diseases Research (CEIDR) is taking on the ‘grand challenge’ of AMR in Liverpool and beyond.
"Antimicrobials underpin modern healthcare. Without them, therapeutic advances in cancer, transplantation, surgery and other infection-prone areas are not possible. Furthermore, many otherwise trivial infections will become life-threatening. In academic health systems, antibiotics have enabled unprecedented research progress, which is now threatened by the inexorable rise of AMR.
AMR has a number of parallels with the climate emergency: it involves a tension between the rights/needs of the individual versus the population; a debate about the fair and appropriate use of a limited resource; a requirement for sustained collective action rather than a short-term fix; the futility of borders of any form to control the problem; and a central requirement to modify behaviours, not just environments and biology, to have any chance of reversing this dangerous and progressive problem.
Yet there has been significant disinvestment in antimicrobial development, a dramatic shrinkage in the number of active researchers around the world, a precipitous loss of corporate knowledge of antimicrobial drug development and a broken economic model where volume-based sales to recoup investment is inconsistent with reserving antibiotics as treatments of last resort.
Antimicrobial resistance does not respect borders or boundaries and yet it is currently managed on a patient-by-patient, hospital-by-hospital basis. We need to move beyond this to tackle AMR at speed and at scale
Addressing the grand challenge of AMR requires interdisciplinary working. The scope of AMR needs broadening from a traditional, academic biomedical focus, to the wider population health reality.
Antimicrobial resistance does not respect borders or boundaries and yet it is currently managed on a patient-by-patient, hospital-by-hospital basis.Professor William Hope
A unique opportunity to contribute to the AMR agenda
Preventing antibiotic uses through vaccination and sanitation is vital for effective antibiotic stewardship and reducing the emergence of resistance – just as important developing and deploying new drugs. Hence, a multitude of disciplines and investigators are required to work collaboratively to bring new approaches to address the problem of AMR.
Through the Centre of Excellence in Infectious Diseases Research (CEIDR), Liverpool now has a unique opportunity to contribute to the national and international agenda in AMR.
CEIDR will directly address AMR in Liverpool and in this process develop a model for creating a ‘learning health system’ that can be subsequently applied to other disease areas.
Liverpool has internationally leading research on the development of new antibiotics, vaccines and materials that can be used to overcome drug resistance. These new products will be increasingly important for patients in the city’s hospitals that have no or few therapeutic options. Liverpool will also harness its world-class research in clinical pharmacology to develop new ways to deliver precise antimicrobial therapy.
Currently, antibiotics are administered as a 'one dose fits all' where individual patients have no way of knowing whether they are well positioned to derive maximum effect from their treatment. Finally, Liverpool is making rapid progress in the development of a civic data cooperative, whereby the use of antibiotics and detection of AMR can be tackled at a city-wide level using state-of-the-art data and technologies. Such a joined system will enable antibiotics to be used appropriately and in a way that is consistent with their significant societal value.
Liverpool is expert in solving difficult problems in complex systems - it learned this through its experiences as one of the leading research centres for global health. The City is well placed to rise to the challenge of providing innovative and creative solutions to AMR. The solutions and cooperative working that will be required are part of the City’s journey to becoming a leading academic health sciences centre where every patient has access to the very latest treatments and ideas through participation in clinical studies."