28 January 2020

Where is the Greta Thunberg of anti-microbial resistance?


As the news broke that Wuhan, a city marginally larger than London, was being put into an effective lockdown to contain the spread of the Coronavirus, a man called Jack stopped whatever he was doing at the gym to ring my LBC show.

Jack was incandescent – as much as anyone who’s called into a radio show from a gym at 22.30 can be. He was raging about a problem that more people need to be raging about, a problem that, without the rage, will end more lives and do more economic damage than even the most doomsday climate prophet can conjure up.

Jack worked for a well-known chemist, his partner is a biomedical scientist, and he described how his friends were asking each other on Facebook whether anyone had a half-course of penicillin left over because they thought they might have a chest infection: Jack, breathless either with anger or over-exertion on a treadmill, called that “disgusting”. By using antibiotics unnecessarily and without completing the course, Jack said his friends were unwittingly and blindly “heading into this obvious death trap”.

His concern is only tangentially related to Coronavirus, as viruses cannot be treated with antibiotics, but the outbreak in Wuhan should focus our minds on the risks of potential pandemics.

In 2016, Lord Jim O’Neill chaired a review of anti-microbial resistance which concluded that, by 2050, 10 million people a year would die because the antibiotics we have won’t work. This could mean a million people dead in India, a million more in China and hundreds of thousands in Europe. People will die from relatively simple surgeries, cancer drugs will stop working and, as well as lives being snuffed out, economies will be ruined: Lord O’Neill, an economist by trade, said AMR is set to cost $100 trillion by 2050 – bear in mind that the global economic output today is about $80 trillion.

If viewing AMR as a health issue or an economic or educational issue doesn’t stop more people in their tracksuits, then perhaps viewing it as a national security issue might. It’s the stuff of disaster movies, but what if senior figures in government were briefed about the national security implications of a pandemic spreading through this country, exacerbated by AMR?

It should be an issue on the agenda at the National Security Council with ministers briefed on the threat posed by AMR, particularly when senior figures in the Government know that the assessment made by public health bodies is that a global pandemic could take hold in as little as eight weeks.

Already, 37,000 people a year are dying in Europe as a result of resistance – that’s up from O’Neill’s estimate of 25,000 four years ago – and there are signs that resistance is now being shown to Colistin, the “drug of last resort” for infections such as pneumonia. We are no longer in the scenario of disaster movies. As Lord O’Neill said to me, “What we scared people about a few years ago might happen sooner”.

It would be wrong to say the British government is doing nothing about AMR: efforts have led to prescriptions for antibiotics decreasing and much work has gone into preventing unnecessary transit of animals. Much still needs to change, however – particularly the attitude of  pharmaceutical companies, but two changes could be made quickly.

The first is that AMR needs to be formally cited and recorded as a cause of death in the UK. That would guarantee a degree of transparency and show, bluntly, that resistance to drugs, as well as the illness itself, can play a big part in mortality. The second is that Britain needs to regain its voice on the world stage as an agitator for change around AMR, to galvanise other nations and, at the same time, to lead awareness efforts in the U.K. about the looming dangers: as O’Neill says, “Where is AMR’s Greta Thunberg?”

The outbreak in Wuhan and the drastic measures being taken by the Chinese authorities to halt it, should serve as a much-needed wake up call that things cannot go on as they are. Calling out an issue of this magnitude should not be left to a raging late-night gym goer.

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Tom Swarbrick is a broadcaster and former adviser to Theresa May