Britain's most senior medical adviser has warned MPs that the rise in
drug-resistant diseases could trigger a national emergency comparable to
a catastrophic terrorist attack, pandemic flu or major coastal
flooding.
Dame Sally Davies, the chief medical officer, said the threat from infections that are resistant to frontline
antibiotics was so serious that the issue should be added to the government's
national risk register of civil emergencies.
She described
what she called an "apocalyptic scenario" where people going for simple
operations in 20 years' time die of routine infections "because we have
run out of antibiotics".
The register was established in 2008 to
advise the public and businesses on national emergencies that Britain
could face in the next five years. The highest priority risks on the
latest register include a deadly flu outbreak, catastrophic terrorist
attacks, and major flooding on the scale of 1953, the last occasion on
which a national emergency was declared in the UK.
Speaking to MPs
on the Commons science and technology committee, Davies said she would
ask the Cabinet Office to add antibiotic resistance to the national risk
register in the light of an annual report on infectious disease she
will publish in March.
Davies declined to elaborate on the report,
but said its publication would coincide with a government strategy to
promote more responsible use of antibiotics among doctors and the
clinical professions. "We need to get our act together in this country,"
she told the committee.
She told the Guardian: ""There are few
public health issues of potentially greater importance for society than
antibiotic resistance. It means we are at increasing risk of developing
infections that cannot be treated – but resistance can be managed.
"That is why we will be publishing a new cross-government strategy and action plan to tackle this issue in early spring."
The issue of
drug resistance is as old as antibiotics themselves, and arises when
drugs
knock out susceptible infections, leaving hardier, resilient strains
behind. The survivors then multiply, and over time can become
unstoppable with frontline medicines. Some of the best known are
so-called hospital superbugs such as MRSA that are at the root of
outbreaks among patients.
"In the past, most people haven't
worried because we've always had new antibiotics to turn to," said Alan
Johnson, consultant clinical scientist at the
Health Protection Agency.
"What has changed is that the development pipeline is running dry. We
don't have new antibiotics that we can rely on in the immediate future
or in the longer term."
Changes in modern medicine have
exacerbated the problem by making patients more susceptible to
infections. For example, cancer treatments weaken the immune system, and
the use of catheters increases the chances of bugs entering the
bloodstream.
"We are becoming increasingly reliant on antibiotics
in a whole range of areas of medicine. If we don't have new antibiotics
to deal with the problems of resistance we see, we are going to be in
serious trouble," Johnson added.
The supply of new antibiotics has
dried up for several reasons, but a major one is that drugs companies
see greater profits in medicines that treat chronic conditions, such as
heart disease, which patients must take for years or even decades.
"There is a broken market model for making new antibiotics," Davies told
the MPs.
Davies has met senior officials at the World Health
Organisation and her counterparts in other countries to develop a
strategy to tackle antibiotic resistance globally.
Drug resistance
is emerging in diseases across the board. Davies said 80% of gonorrhea
was now resistant to the frontline antibiotic tetracycline, and
infections were rising in young and middle-aged people. Multi-drug
resistant TB was also a major threat, she said.
Another worrying
trend is the rise in infections that are resistant to powerful
antibiotics called carbapenems, which doctors rely on to tackle the most
serious infections. Resistant bugs carry a gene variant that allows
them to destroy the drug. What concerns some scientists is that the gene
variant can spread freely between different kinds of bacteria, said
Johnson.
Bacteria resistant to carbapenems were first detected in
the UK in 2003, when three cases were reported. The numbers remained low
until 2007, but have since leapt to 333 in 2010, with 217 cases in the
first six months of 2011, according to the latest figures from the HPA.
