A groundbreaking new series on antimicrobial resistance (AMR) from The Lancet, one of the world’s leading science journals, has been developed with the vital involvement of researchers from the South Africa hub of the Centres for Antimicrobial Optimisation Network (CAMO-Net).
Professor Marc Mendelson and Associate Professor Esmita Charani, CAMO-Net co-leads based at the University of Cape Town, have contributed to the new Series. Marc Mendelson, an expert in infectious diseases and AMR, and Esmita Charani, whose research explores social constructs affecting health behaviours in AMR and antimicrobial stewardship, have provided critical insights into addressing AMR through a lens of global equity.
In 2016, a UN high-level meeting brought global attention to the health crisis of AMR. Despite subsequent commitments by 178 countries to develop national action plans, fewer than a fifth of these plans have been adequately funded or implemented. As the UN prepares for another critical meeting on AMR in September 2024, the new Lancet Series provides essential insights into the actions needed to address this urgent threat. This Series, developed with the contributions of CAMO-Net, emphasises that while AMR poses a severe global health risk, effective strategies to address it are both available and actionable.
CAMO-Net is a global partnership dedicated to optimising antimicrobial use and addressing AMR around the world. With a mission to enhance global research through equitable and sustainable practices, CAMO-Net operates through five national hubs in Brazil, India, South Africa, Uganda, and the UK. These hubs, supported by technical centres in Ghana, Malawi, and Thailand, and shadow sites in Bangladesh, Pakistan, and Timor-Leste, focus on developing contextually relevant tools, technologies, and guidelines for antimicrobial use.
Key Findings from The Lancet Series
The Lancet Series on AMR highlights the profound and immediate impact of AMR, reporting that bacterial infections account for 7.7 million deaths annually, with nearly 5 million of these linked to drug-resistant bacteria. Notably, improving existing infection prevention methods could prevent over 750,000 deaths each year in low- and middle-income countries (LMICs). These methods include vaccination, access to safe water and sanitation, and stringent hospital infection control. Effective hand hygiene practices and regular equipment sterilisation in healthcare settings alone could save up to 337,000 lives annually.
A Call for Global Action
The Series’ authors highlight the necessity of sustainable access to effective antibiotics. They warn that failing to prioritise AMR now could lead to a steady increase in the global death toll from infections linked to AMR especially among infants, the elderly, and individuals with chronic illnesses.
Professor Marc Mendelson said, “Antibiotics are the cornerstone of modern medicine, and their preservation is essential to ensuring that we can continue to reduce illness and save lives from bacterial infections. By prioritising equitable access to these vital medicines and investing in robust infection prevention methods, we can prevent hundreds of thousands of deaths annually. The findings focus on actionable global targets that can be achieved by 2030: 10% reduction in mortality from AMR. A 20% reduction in inappropriate human antibiotic use. A 30% reduction in inappropriate animal antibiotic use. Only by taking strong action now can we ensure the availability of effective antibiotics for this and future generations.’
Path Forward: UN Meeting and Beyond
As the UN prepares for its upcoming high-level meeting on AMR, the Lancet Series offers a clear, evidence-based roadmap for action. It proposes ambitious yet achievable targets for 2030, including a 10% reduction in mortality from AMR, a 20% reduction in inappropriate human antibiotic use, and a 30% reduction in inappropriate animal antibiotic use.
By integrating robust infection prevention strategies, expanding access to essential antibiotics, and fostering equitable research and development, the Lancet Series aims to mitigate the global threat of AMR. With significant contributions from CAMO-Net site leads/principal investigators in South Africa, this Series provides actionable guidance to policymakers, emphasising that the tools to address AMR are already available. Immediate coordinated global action is needed to implement these strategies and safeguard public health.
Dr Esmita Charani underscores the urgency of developing evidence-based, contextually relevant antibiotic stewardship strategies in LMICs, noting: “Whilst new antibiotics are needed, they must be affordable to everyone. Alongside investment in antibiotic R&D global targets are required for reducing inappropriate antibiotic use. Our modelling study has demonstrated that existing interventions that have the greatest impact in LMICs include improvements in infection prevention and control, universal access to water, sanitation, and hygiene services, from universal coverage of high-priority childhood vaccines. This doesn’t mean stewardship is ineffective, rather that we need to expand the boundaries of stewardship and consider how different context will need to prioritise different interventions’
The collaboration of CAMO-Net Principal Investigators in the Lancet Series exemplifies the network’s commitment to addressing AMR through equitable global research and sustainable practices, providing invaluable expertise to shape the future of antimicrobial optimisation and AMR mitigation.
