GHP August 2015

ghp August 2015 | 19 research Picture a world where a cut finger could kill you. You don’t have to look too far ― before the discovery of antibiotics just 80 years or so ago it was common for women to die from post-childbirth infections, and diseases such as tuberculosis were huge killers. The discovery of antibiotics is still considered one of the greatest medical achievements of the 20th century. Since Sir Alexander Fleming accidentally discovered penicillin growing on a petri-dish of bacteria, antibiotics have saved the lives of millions. From treating minor cuts and grazes to their use in major operations and serious diseases, these drugs have drastically improved our quality of life and increased our lifespan. As we now know, antibiotic overuse and misuse – in agriculture and human medicine – has led to a grow- ing number of bacteria in humans, animals and the environment that are resistant to them. Sir Alexander Fleming himself predicted the dawn of this superbug battle, on collecting a Nobel Prize for his discovery: “It is not difficult to make microbes resistant to pen- icillin in the laboratory by exposing them to concen- trations not sufficient to kill them…” Certain strains of tuberculosis, methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile, for example, do not respond well to current antibiotics. And we are now seeing the worrying emergence of multidrug-resistant bacterial strains which have shown resistance to many, or even all, available antibiotics. Fighting resistance through research Tackling the problem of antibiotic resistance (AMR) will depend heavily on research. First, it will be crucial to understand the many factors that lead to resistance. This includes environmental factors such as the use of antibiotics in agriculture and fish farming, and human behaviours like antibiotic over- prescribing and hygiene practices. In order to reduce and control AMR, it will be essential to address these behaviours; for example, by changing how farmers and vets produce livestock for human consumption, and changing attitudes towards infection, prescrib- ing, and the use of antibiotics among the public and health care professionals in the UK and abroad. We also urgently need to develop new drugs and treatments to combat the rise of resistant bacteria. Identifying parts of resistant bacterial cells that could be used as new drug targets, for example, will allow scientists to come up with ‘next generation’ antibiot- ics that can kill these cells quickly without harming the patient. The development of more specific, dis- ease-tailored antibiotics will also help us to cut down on the number of drugs being used. The UK Medical Research Council (MRC) plays a pivotal role in the international race to find solu- tions to antimicrobial resistance. MRC scientists are taking unique and new approaches to AMR that will help to improve our understanding of re- sistance, and ultimately, our ability to develop new drugs and therapies. Cross-discipline collaboration – from farms to pharmacies Strong ties between academia and industry are crucial to helping scientists identify treatments and diagnostics that are likely to make it to the clinic. It will also be essential for different scientists to work together to find new classes of drugs, and to potentially revive old drugs with new science. As we work to address the scale of the AMR problem, we will need to involve experts from further scientific areas such as engineers, environmentalists, social scientists and economists. To stimulate a rich cross discipline research envi- ronment, the MRC leads the seven UK research councils in an historic ‘war cabinet’ , established to co-ordinate and expedite research across all areas impacted by antimicrobial resistance - from labs to livestock, farms to pharmacies, drawing together a range of scientific expertise from the UK and abroad. In addition, the MRC established the AMR Funders’ Forum to encourage a coordinated approach to funding research. It brings together the seven re- search councils with health departments, govern- mental bodies and charities that either provide sup- port for AMR research or have an interest in AMR. The Forum provides a strategic overview of AMR research in the UK and to create a shared vision for the future of AMR research and its potential impact on policy and treatments. AMR is a global problem and since 2012 the MRC has been involved in the EC-funded Joint Program- ming Initiative on Antimicrobial Resistance (JPIAMR) , which co-ordinates research in 19 European countries, plus Israel and Canada, to address AMR on a global scale. As part of this work, we are leading a mapping exercise to pull together all the research carried out in these countries over the last seven years. This will help us to identify gaps and opportunities for future AMR research. We are also broadening our efforts outside of Europe, working with colleagues in India and China to tackle AMR. Professor Sir John Savill, Chief Executive of the Medi- cal Research Council said: “Only 100 years ago, a quarter of all deaths were due to bacterial infec- tions. We know there’s no magic bullet to the AMR problem. Tackling the issue will depend heavily on research that is connected, multidisciplinary and that takes global perspective. Real change needs proper global investment. What we do know is that the UK model on AMR research is an exemplar of how to bring researchers from all disciplines and back- grounds together. We have the expertise, experience and the imperative. We need to act now.” Find out more For funding opportunities and further information go to crobial-resistance/