Refocusing AMR in the post-COVID-19 era: Challenges and opportunities

Abstract

Antimicrobial Resistance (AMR) has become one of the top global public health issues as declared by the World Health Organization. It has been estimated that there were 4.95 million deaths associated with bacterial AMR in 2019, including 1.27 million deaths attributable to bacterial AMR. The latest global and local situation on AMR would be presented, with focus on rising trends of multi-drug resistance organisms such as Methicillin-resistant Staphylococcus aureus, carbapenem-resistant Acinetobacter, carbapenem-resistant Enterobacteriaceae, and vancomycin-resistant enterococcus. The impact of COVID-19 on AMR, including both antimicrobial utilization and pattern of resistant bacteria would be examined. To combat the AMR pandemic, Hong Kong has launched the second Strategic and Action Plan on AMR which adopts six key strategic areas namely strengthen knowledge through surveillance and research; optimise use of antimicrobials in humans and animals; reduce incidence of infection through effective sanitation, hygiene and preventive measures; improve awareness and understanding of AMR through effective communication, education and training; promote research on AMR; and strengthen partnerships and foster engagement of relevant stakeholders. Positive outcomes have been achieved and new initiatives are underway with ultimate goal to reverse the trends of emergence of AMR in Hong Kong. International collaboration and concerted efforts under the “One Health” approach is essential to tackle the challenges ahead including poor incentives for the pharmaceutical industry to invest in new drug development, risk of AMR in food, and role of the environment in evolution of AMR. Yet, opportunities do exist including sustained effect of non-pharmacological public health interventions, novel anti-bacterial alternatives such as faecal microbiota transplantation and phage therapy, and new financial model for drug development.