Review of AMR progress since 2013

NOAH FONGWEN: In this step, we’ll talk about two important reviews on AMR progress, the Lancet Commission and the Chatham House Review. In 2019, the medical journal the Lancet conducted a review of the successes and challenges of AMR programmes worldwide since the original AMR commission in 2013. Their findings can be summarised in the following three points. There has been increased awareness and political commitment leading to a high level meeting of the United Nations General Assembly in 2016. There’s been good progress on banning irrational drug combinations, commitments to ban colistin as a growth promoter in animals, improve hospital infection control, and better antimicrobial stewardship. However, there has been limited progress on funds mobilised and relaxed regulatory barriers to enable new antibiotic development.

In addition, the commission identified sustained funding for AMR and globally harmonised targets to monitor progress as priorities to move forward.

The Chatham House, an international think tank based in the United Kingdom, was funded by the Wellcome Trust to assess AMR progress against the recommendations of the O’Neil report. They found the following. They found that little progress has been made on the O’Neil report’s central and most expensive recommendations, transforming research and development incentives for antibiotics, vaccines, and diagnostics. They also found that there has been significant advances in reducing antibiotic use in agriculture, particularly in high income countries. But there is a long way to go in low-and-middle income countries. They found that there has been greater investment in awareness raising. But questions remain about its impact and effectiveness in changing behaviour.

Finally, they found out that proposals to restrict over-the-counter sales of antibiotics have foundered in the face of poor living conditions and access to health care in LMICs.