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This House of Lords Library briefing has been prepared for the debate in the House of Lords on the final report of the Review on Antimicrobial Resistance, Tackling Drug-resistant Infections Globally: Final Report and Recommendations, scheduled for 15 September 2016. The briefing includes background to the subject of antimicrobial resistance (including commentary from the Review itself and from the World Health Organisation (WHO)), a summary of the recommendations and economic costings in the Review, and brief information on how the UK and the WHO are already looking to combat the issue.

The Review (which was commissioned by the Coalition Government in July 2014) describes antimicrobial resistance as “a natural process whereby microbes evolve to be able to resist the action of drugs, making them ineffective”. Over time, this can lead to antibiotics (and other antimicrobials) becoming less effective or, in some cases, ineffective entirely. Although describing it as a “natural phenomenon”, the WHO state that the rate of resistance is accelerated by the overuse or misuse of antibiotics (both in humans and in animals) and by poor infection prevention and control practices. The Review estimated that 700,000 people worldwide a year currently die of resistant infections, and that (if action is not taken) by 2050 this number could rise to around 10 million a year. It also estimated that this would cost around a cumulative $100 trillion in global economic output.

Emphasising that the issue needed to be dealt with on a global basis, the Review set out the importance of addressing issues connected to the supply and demand of antimicrobials. The final report of the Review set out ten recommendations to work towards this. Of these, four were highlighted as “particularly important” in the foreword to the report by Lord O’Neill of Gatley, who led the review. These were: a global public awareness campaign to educate people about the issue of drug resistance; introducing market entry rewards for the development of certain successful new drugs; stimulating the market and development of diagnostic technologies to reduce the unnecessary prescription of antimicrobials; and reducing the use of antibiotics in agriculture. The Review estimated that its recommendations would cost around $40 billion globally over a decade.

The Coalition Government published a five-year strategy for addressing AMR in 2013 and, in 2015, the WHO published its global action plan on the issue. On 21 September 2016, the issue is due to be discussed at the meeting of the United Nations annual General Assembly as a High Level Meeting agenda item for the first time.

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