Transcript Ppra
Transcript Ppra
Transcript Ppra
SALLY DAVIES: So people are beginning to realise that drug resistant infections
are here and killing people, but most people see the underlying cause, anti-
microbial resistance, AMR, as a problem particularly of the future. That doesn't
recognise the reality that already in the States, at least 23,000 people are
dying every year of drug resistant infections, at least 25,000 in the European
Union, and if you look at India, then nearly 60,000 babies are dying every year
of sepsis due to drug resistant infections. So AMR is here in a big way, and we
need to focus people on that. We've got some focus on that. We've got high
level political support through G20, G7, the United Nations.
Part of the problem is the complexity, that people find it difficult to understand
we have a problem of drug resistant infections in humans that extend hospital
admissions, double the cost of a hospital admission, double the mortality of
that infection.
If we don't act urgently on AMR, then the current 700,000 deaths a year across
the world will go up to probably about 10 million a year in 2050. Thinking
about that, that's more than we have dying of cancer at the moment, which is
about 8 million deaths a year. And the impact on people's economies is
dramatic. It's going to take out of the global economy the equivalent of the UK
economy. It will push an extra 28.3 million people into poverty if we don't act
on drug resistant infections now. So we've got to take action in a lot of areas.
We've got to start by making sure that people get the drugs that they need,
and access is a big issue.
And there's this tension between access and excess because we know more
people are dying at the moment because they're not getting antibiotics, but
overuse drives AMR and drug resistant infections. And that means we have to
take action on getting new antibiotics, using the antibiotics we've got better,
stopping growth promotion use in animals, stopping their use in agriculture
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except to treat serious infections, and importantly using rapid diagnostics so
that people know when it's a bacterial infection, ideally, what the infection is
so the antibiotics are targeted.
To sort AMR in the human field, we've got to kind of put AMR into the whole
area of health care at its broadest level. It underpins a lot of delivery of
sustainable development goals. We won't get there and then eliminate poverty
if we don't sort AMR. AMR is a key part of universal health coverage. It's a key
part of infection prevention and control. We need really to think about AMR as
we look at every lens for health care.
JEREMY FARRAR: The world is-- I don't use this word often-- but the world
really is facing a crisis with drug resistance. We've had 60 or 70 years of being
able to treat most infections, prevent most infections, and as a result, all sorts
of things in medicine have been made possible. Surgery is now possible
because we can control infections. Childbirth is now relatively safe around the
world because we control infections. Cancer therapies are possible because we
can control infections. Treatment of diabetes is possible. People are much more
prone to infection with diabetes. So the whole of modern medicine rests on the
ability to control infection.
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If we lose that ability, if drug resistance spreads as it is doing, and we don't
address it, then it's not just infectious diseases that are affected. It's the whole
of modern medicine, and that's a devastating scenario. So this is urgent. From
where we are today to having solutions is going to take years, and if we don't
start this work academically, in the commercial sector, changing behaviours in
society, if we don't start that work now, in a few years time, we will face this
apocalyptic scenario where surgery becomes impossible, childbirth becomes a
much higher risk, and children and adults will die of drug resistant infections.
That is the future, but actually that's already happening now.
So we've been a privileged position for 70 years, which we've abused, which is
that we haven't really needed to define the infection that's happening because
we have these wonderful broad spectrum antibiotics that would treat almost
everything. We're losing that ability now, and we have to become much more
specific at this infection requires this antibiotic. And in order to do that, you
have to define and diagnose that infection, and we need diagnostics to tell us
what the pathogen is, what the infection is.
So diagnostics have been the Cinderella of medicine in a way, and it's because
we've become so good at medicine that, often, we felt that we didn't need it.
We could treat patients. We could conduct public health work with a sense of
what the diagnosis was without having to have the specific. I think what drug
resistance does is change that dynamic. We need to incentivize the academic
sector, the scientific sector, and it won't just be from biomedicine.
And I think until you galvanise the public support for an appreciation this is
affecting people's lives today, then it's difficult to galvanise them to change
behaviour, to support the advances in diagnostics. So I think we need to make
the case that there is an urgency to this. This is not something that will only
happen 20 or 30 years from now. This is happening today, and things that
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we've all taken for granted-- hip operations, cancer therapies, diabetes-- would
all be affected if we lose these remarkable class of drugs.
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