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Jargon, lack of incentives hinder antimicrobial plans in Europe
Confusing language clouded by jargon and a lack of research and development incentives are some of the flaws limiting the success of antimicrobial resistance strategies in Europe, researchers concluded.
In addition, a lack of measurable outcomes has made it difficult to assess how well health officials are implementing the strategies recommended by WHO for European Union countries, they wrote in report for the United Kingdom All-Party Parliamentary Group (APPG) on Antibiotics. The conclusions came following the researchers’ assessment of the EU and U.K. plans to implement the WHO recommendations issued in 2011.
“The biggest weakness is the ambiguous nature of the words employed in the recommendations,” researcher Laura Piddock, PhD, a professor of microbiology at the University of Birmingham, U.K., said in a news release. “This ‘jargon’ may limit the impetus for decisive government action in some areas and pose a challenge to finding evidence of fulfillment of the [antimicrobial resistance, or AMR] strategy aims.”
Piddock and Victoria Wells, of the British Society for Antimicrobial Chemotherapy, also wrote a related commentary in The Lancet Infectious Diseases.
In the APPG report, Piddock and colleagues pointed out what they deemed shortcomings in the EU and U.K. efforts. EU states have not uniformly executed recommendations, they said.
“Available evidence suggests that, although some EU member states have been successful in the implementation of many of the WHO recommendations, there are others that appear to have been overlooked,” Piddock and colleagues wrote. “In particular, there was a conspicuous lack of evidence to suggest any activity to restrict nonprescription use of antibiotics by people or off-label veterinary use of certain new or critically important antibiotics to human medicine. Likewise, it appears that little has been done to evaluate the need for incentives to stimulate discovery, research and development of veterinary medicines to increase the likelihood that drugs will reach the market at the rate required to combat AMR.”
The researchers also criticized efforts in the U.K., although they stressed that British health officials have taken “significant steps” in executing a plan. Specifically, officials there have fallen short in “education and public awareness, veterinary and agricultural use, and incentives for antibiotic discovery, research and development,” Piddock and colleagues said. “This may be due in part to a lack of action by regional authorities. However, it may also be due in part to a lack of objective and tangible outcomes by which to measure success.”
To alleviate the shortcomings, the researchers made several recommendations. They suggested using more specific objectives that are measurable and showing how strategies should comply with the WHO plan.
They also recommended developing educational tools, concerning AMR and antimicrobial stewardship, for health care providers, veterinary care providers and the public. Reviewing the development of new drugs and using simple, clear language were among other recommendations Piddock and colleagues made.
In September 2016, the U.N. General Assembly held a meeting on combating AMR that included a commitment to WHO’s Global Action Plan on Antimicrobial Resistance. During the meeting, officials confronted excessive antimicrobial prescriptions and the use of the drugs in feeding livestock, among other issues.
They also committed to spurring investment in new therapeutic technology and research, and encouraging the public to support stewardship, among other measures. Failure to tackle the causes of AMR could bring dire consequences, then-U.N. Secretary General Ban Ki-moon warned.
“You are here today because you recognize that antimicrobial resistance poses a fundamental threat to human and animal health, sustainable development, to sound economies and social cohesion,” Ki-moon told attendees. “The commitments you make today must be turned into swift, concerted action.”– by Joe Green
References:
Wells V, Piddock LJV. Lancet Infect Dis. 2017;doi:10.1016/S1473-3099(17)30633-3.
Disclosures: Piddock reports grants from Roche, the U.K. Medical Research Council and the U.K. Biotechnology and Biological Sciences Research Council.