It is no secret that there is a desperate need for a response to antimicrobial resistance, so what are we doing about it? Not nearly enough and Dr Peter Jackson wants to change that…
There is a growing sense that, with AMR, we are on the cliff-edge of a disaster, is that overstating?
I prefer to use the analogy of an unstoppable rising tide. AMR is not a ‘tsunami’ that will suddenly appear with no warning. We know that resistant organisms are out there and that multi-drug resistance is on the rise; however, this is inevitable, as Fleming said shortly after discovering Penicillin, because the microbes will respond to the evolutionary pressure of new antibiotics. Given the long lead times of drug development, the real challenge of AMR is to take action now against the unavoidable rising tide of resistance so that we have the new drugs, diagnostics and vaccines we will need in 5, 15 and 25 years’ time.
How much of the problem is due to over-prescription?
Over prescription is only one part of the problem but the UK has made great strides in educating healthcare professionals and patients on this in recent years. In many countries however, antibiotics are available from corner shop pharmacies without the need for a prescription, and over 80% of all antibiotic use worldwide is in animals. That’s why we need a global multi-faceted approach to prevent resistance developing in the first place.
So, why are so few scientists actually working on the problem of AMR?
There are many dedicated researchers in universities and institutes and it’s great to see research funding initiatives attracting new students into the field. Sadly the situation in industry is very different. Big pharma has reduced its presence in antibiotics research over the past 30 years as the sector has become genericised with low returns on investment. Additionally, biotech has found it increasingly difficult to attract investment for anti-infective R&D so we have seen a significant decline in the number of researchers in industry - estimated at fewer than 500 worldwide by the Boston Consulting Group in a report for the G20.
Practically speaking what will the AMR Centre aim to do?
The AMR Centre was established to address three issues: funding, capacity and capability. Extensive consultation with small-to-medium enterprises highlighted the lack of funding as a key barrier to growth. There is also a critical lack of expertise, with two generations of antibiotics researchers missing from the sector, and an associated lack of capacity to handle new projects. Using the state-of-the-art facilities at Alderley Park in Cheshire, we have re-built a core capability in pre-clinical development, inlcuding medicinal chemistry, microbiology and project management. We have also rebuilt capacity in our network of providers in the AMR cluster at Alderley Park - the largest AMR-focused business cluster in Europe.
The Francis Crick Institute, the Wellcome Genome Campus... centres of excellence and expertise seem to be a growing part of the life science infrastructure, why is the approach so successful?
This is simply down to scale. It is extremely difficult and expensive to develop new drugs - the expertise required combined with the cost and high attrition rates in development mean that hundreds of millions of dollars are needed to fund the process. Centres of excellence and expertise can greatly facilitate this. Furthermore, the focus they can provide allows the development of specialised clusters, which offer an attractive location for scientists and companies to relocate to.
Dr Peter Jackson is Executive Director of the AMR Centre, which is spearheading the UK’s response to AMR.