Posted on Jun 18, 2016

Professor Tim Inglis and Dr Barry Mendelawitz Applecross Rotary Members and Project leaders

   Key facts
  • Antibiotic resistance is one of the biggest threats to global health, food security, and development today.
  • Antibiotic resistance can affect anyone, of any age, in any country.
  • Antibiotic resistance occurs naturally, but misuse of antibiotics in humans and animals is accelerating the process.
  • A growing number of infections – such as pneumonia, tuberculosis, and gonorrhoea – are becoming harder to treat as the antibiotics used to treat them become less effective.
  • Antibiotic resistance leads to longer hospital stays, higher medical costs and increased mortality.
The AMR Awareness Project aims to provide information about the problem by
  • Reducing the chance of infection by personal hygiene and vaccination;
  • Does the infection really need antibiotics?
  • If an antibiotic is needed which one to use and why

AMR Aware Inc

Members of the Rotary Club of Applecross have formed a not for profit organisation, AMR Aware Inc, with the mission to promote AMR awareness and information. The steering group also contains senior veterinarians, public health physicians, microbiologists, past district governors of Rotary and others from diverse backgrounds.

AMR Aware is seeking sponsors to support promotion and marketing programs throughout Australia.

AMR, antimicrobial resistance to antibiotics, is increasing and becoming a serious global health problem.

Antimicrobial resistance (AMR) occurs when microorganisms such as bacteria, viruses, fungi and parasites change in ways that render the medications used to cure the infections they cause ineffective. When the microorganisms become resistant to most antimicrobial drugs they are often referred to as “superbugs”. This is a major concern because a resistant infection may kill, can spread to others, and imposes huge costs to individuals and society.
This a serious international problem. The World Health Organisation has addressed this issue and developed a ‘Global Action Plan’.  
Antimicrobial resistance is occurring everywhere in the world, compromising our ability to treat infectious diseases, as well as undermining many other advances in health and medicine. The goal of the draft global action plan is to ensure, for as long as possible, continuity of successful treatment and prevention of infectious diseases with effective and safe medicines that are quality-assured, used in a responsible way, and accessible to all who need them.
To achieve this goal, the global action plan sets out five strategic objectives:
  • to improve awareness and understanding of antimicrobial resistance;
  • to strengthen knowledge through surveillance and research;
  • to reduce the incidence of infection;
  • to optimize the use of antimicrobial agents; and
  • develop the economic case for sustainable investment that takes account of the needs of all countries, and increase investment in new medicines, diagnostic tools, vaccines and other interventions.
The AMR Review 2015-2016 commissioned by the UK Government and the Wellcome Trust concluded that if AMR proceeds at its current rate it poses a major threat to global health greater than terrorism.
The Australian Government Department of Heath has produced a National Antimicrobiological Resistance Strategy 2015 - 2019.
Already more than 700000 people die of drug resistant infections every year. It is estimated that by 2050 if AMR continues at its current rate there will be 10-11 million deaths per year with unestimated morbidity at an accumulated cost of 100 trillion US dollars.
This is a global problem with implications for human, animal and plant health- but needs widespread local actions.
Antibiotics underpin much of current medical practice. If they lose their effectiveness because of microbes’ resistance many surgical procedures may become much more dangerous because of the risk of infection: joint replacement, bowel surgery and caesarean section are examples. Similarly, treatments involving immune suppression, such as chemotherapy for cancer, will also be more liable to be complicated. At increased risk will be the growing number of patients with diabetes mellitus and patients having renal dialysis.
The number of deaths is frightening but this will be accompanied by increased hospitalisation, personal and family suffering and decreased life expectancy after serious episodes of sepsis.
The escalation of drug resistant infections has been driven by widespread inappropriate use of antibiotics in humans, animal meat production and in agriculture. It is estimated that at least 50% of prescriptions of antibiotics for humans are not indicated as antibiotics have no effect on viruses.
AMR at the extremes of life presents a greater risk of morbidity and mortality.
No new antibiotics have been delivered to market for over 20 years.
Strong action in Australia is also needed to combat the scourge of AMR.
The UK AMR Review proposes 10 action fronts. Number ONE is a massive global awareness program to be conducted by government agencies with the enlisted support of non-government agencies and other groups.
AMR AWARE was established to be one of these agencies.
The three basic messages to be conveyed are simple:
  1. Promote immunisation programs
  2. Promote sanitation/hand hygiene programs particularly to the young and elderly
  3. Empower better decision making about the prescription and use of antibiotics.
More information is available on the AMR website.
The Rotary Club of Applecross’s AMR Project is in support of the first recommendation of an 84-page AMR review  which was commissioned by the UK Government and the Wellcome Trust in May 2016.
This report examines the problem and provides recommendations to tackle AMR in a global way. It concludes ‘… The magnitude of the problem is now accepted. We estimate that by 2050, 10 million lives a year and a cumulative 100 trillion USD of economic output are at risk due to the rise of drug-resistant infections if we do not find proactive solutions now to slow down the rise of drug resistance. Even today, 700,000 people die of resistant infections every year. Antibiotics are a special category of antimicrobial drugs that underpin modern medicine as we know it: if they lose their effectiveness, key medical procedures (such as gut surgery, caesarean sections, joint replacements, and treatments that depress the immune system, such as chemotherapy for cancer) could become too dangerous   to perform. Most of the direct and much of the indirect impact of AMR will fall on low and middle-income countries…’
   Deaths Attributable to AMR every year by 2050  
           (Source Review on Antimicrobial Resistance 2016)
   Deaths Attributable to AMR every year by 2050  
         (Source Review on Antimicrobial Resistance 2014)
The Report recommendations include:
Firstly, the specific steps to reduce demand are:
  • A massive global public awareness campaign
  • Improve hygiene and prevent the spread of infection
  • Reduce unnecessary use of antimicrobials in agriculture and their dissemination into the environment
  • Improve global surveillance of drug resistance and antimicrobial consumption in humans and animals
  • Promote new, rapid diagnostics to cut unnecessary use of antibiotics
  • Promote development and use of vaccines and alternatives
  • Improve the numbers, pay and recognition of people working in infectious disease
Secondly, we must increase the number of effective antimicrobial drugs to defeat infections that have become resistant to existing medicines
  • Establish a Global Innovation Fund for early-stage and non-commercial research
  • Better incentives to promote investment for new drugs and improving existing ones
None of this will succeed without building a global coalition for action on AMR and we consider that to be our tenth recommended intervention
  • Build a global coalition for real action – via the G20 and the UN
The Rotary Club of Applecross’s AMR Project is in support of the first recommendation, ‘A massive global public awareness campaign’, of an 84-page AMR review which was commissioned by the UK Government and the Wellcome Trust.