Tackling antimicrobial resistance

Drug-resistant infections already kill hundreds of thousands a year globally, and by 2050 that figure could be more than 10 million. The economic cost will also be significant, with the world economy being hit by up to $100 trillion by 2050 if we do not take action.”

Jim O’Neill, Chairman of the Review on Antimicrobial Resistance

In Europe alone about 25,000 people die each year from drug-resistant microbial infections, similar to the number who die in road traffic accidents, with an estimated economic impact of at least €1.5 billion. Many surgery and cancer therapies, that could make people more prone to bacterial infections, could be rendered obsolete in the absence of effective antibiotics. AMR could also significantly threaten global food production: without effective antimicrobials (including fungicides), crop yields would decrease significantly while the global population will still be increasing.

“It is not difficult to make microbes resistant to penicillin…”.

Sir Alexander Fleming, Nobel Lecture, December 1945

The emergence of AMR is not unexpected but resistance is greatly accelerated by the overuse and misuse of antimicrobials in health and agriculture. Addressing AMR is complicated by social and economic factors that need to be solved in parallel to the scientific challenges.

Policy and funding matters

The UK’s current response includes a Five Year Antimicrobial Resistance Strategy, published in 2013, and a Government-announced independent Review, to examine the economic issues surrounding AMR. In addition, the UK public voted for the £10 million Longitude Prize to create a “cost-effective, accurate, rapid, and easy-to-use test for bacterial infections” so health professionals can administer the right antibiotic at the right time. Also in 2014, the Antimicrobial Resistance Funders’ Forum was established, allowing key research funding agencies including the Research Councils, Department of Health (DoH), and charities to coordinate, maximise funding impact and raise the profile of the UK’s AMR research base.

More public and private investment is required for fundamental, blue-sky, chemistry research to enable advances in AMR understanding, and to translate new discoveries into treatments, diagnostics and mitigation strategies. Clearly, mechanisms to support collaboration between academia, industry, clinicians and funders will be critical. Professor Chris Schofield (University of Oxford) outlined how “work in the resistance field needs to be truly interdisciplinary” in his recent RSC News opinion piece. We need to ensure that academic research is fully supported and translational mechanisms provided enabling scientists to address this challenge fully. The creation of AMR centres of excellence is one possible way to link knowledge across the chemical sciences, microbiology, biochemistry, pharmacology, materials and the clinical sciences, thereby linking drug discovery expertise with centres of clinical excellence.

The role of chemistry

Our roadmap, Chemistry for Tomorrow’s World, highlighted many of the contributions that the chemical sciences make in tackling global challenges, including infectious disease.

Chemistry is central to understanding AMR and its causes, as well as developing strategies to overcome it. To highlight chemistry’s impact, we have created an AMR web collection which will be freely available for one month starting on 18^th May to coincide with the 68^th World Health Assembly. We will focus throughout the year on advocacy and community support to advance research in tackling AMR.

Our series of conferences showcase cutting-edge research and support the development of the next generation of researchers. Amongst the advances discussed at our recent Directing Biosynthesis conference were innovative methodologies for the discovery of novel antimicrobials, and synthetic biology approaches to the production of analogues of structurally complex and synthetically challenging antibiotics.

“The overwhelming majority of antibiotics in clinical use are natural products or semisynthetic derivatives. Although approaches based on synthetic compounds have proved successful in other areas of drug discovery they have largely failed to deliver new antibiotics. There is thus an urgent need to develop novel approaches for antimicrobial natural product discovery, as well as new ways to engineer the biosynthetic pathways for clinically-used compounds to produce new derivatives.”

Greg Challis, University of Warwick, Member of the Directing Biosynthesis IV Scientific Committee

The Chemistry in Health symposium at the end of May will feature five of our prize and award winners who will speak about their research in areas such as understanding infectious disease and the generation of new antibiotics. The programme will include a poster session and lecture on the exploration of new or improved platforms for collaboration. Professor John Watson, Deputy Chief Medical Officer (DoH) who will present the winners with their medals commented:

“I am delighted to have the opportunity to contribute to this event. Research is identified in the UK’s national strategy as an integral part of the action necessary to tackle the threat of AMR.  A wide range of research is needed, from work that will contribute to the development of new drugs, alternative treatments and diagnostics to more effective ways to change the ways we use antimicrobials.  Funders within the UK are working together, and collaborating with international partners, to enable this essential work to move forward rapidly”

Multiple sectors and disciplines will need to work together on any viable solutions for AMR. Therefore we have joined six other learned societies, including the Society of Biology and the British Society of Antimicrobial Chemotherapy, in a partnership to support knowledge sharing and to develop collaborations.

Many of our members are researching ways to tackle AMR and in November, working with members of the Chemistry Biology Interface Division, we are partnering with the British Society of Antimicrobial Chemotherapy to organise a workshop aimed at understanding and addressing antimicrobial resistance mechanisms.

We are also supporting a series of regional workshops to bring together researchers to better understand the evolution and circulation of resistance in humans, animals, food, water, and in the environment. Before the end of the year we will hold a panel discussion of leading experts from Industry, Academia and Government, to share ideas of the most promising ways to tackle AMR and identify how to implement these solutions.

Find out more at www.rsc.org/health

AMR Programme 2015

• Chemistry in Health 2015: Towards new therapeutics to fight disease, 26 May, London, UK
• Antimicrobial resistance web collection, all articles are free to view for one month from 18 May
• Antimicrobial resistance: environments, evolution and transmission: 25 June, London, 03 July, Dundee and 07July, Nottingham
• International Symposium on Antibacterial Agents: Chemistry and Mechanisms of Action, 25-27 August, Lanzhou and Tianjin, China
• Antibiotic resistance mechanisms workshop, in partnership with the British Society of Antimicrobial Chemotherapy, 26-27 November, Birmingham, UK