The next item of business is a members’ business debate on motion S4M-11602, in the name of Jim Eadie, on the Royal Pharmaceutical Society in Scotland and European antibiotic awareness day. The debate will be concluded without any question being put.
Motion debated,
That the Parliament congratulates the Royal Pharmaceutical Society in Scotland on increasing awareness of the issue of antimicrobial resistance; notes its efforts to draw attention to the need for new antibiotics to avoid a situation where simple infections and infections as a result of routine surgery become fatal; welcomes its support of the European Antibiotic Awareness Day on 18 November 2014; considers the raft of resources made available to healthcare professionals in primary and secondary care by the Scottish Antimicrobial Prescribing Group (SAPG) to have demonstrated an impact through the decrease of 6.5% in the number of prescriptions for antibiotics in 2013-14; commends healthcare workers for their results to date; further notes the significant challenge that antimicrobial resistance continues to present worldwide; welcomes the SAPG’s focus this year on the cooperation between the Royal Pharmaceutical Society in Scotland, Community Pharmacy Scotland and Pharmacy Voice to distribute a resource pack to all community pharmacies in Scotland, including a patient self-help guide to treating infection; acknowledges the role that healthcare professionals, patients and the public play in preserving the effectiveness of antibiotics; notes the opportunity for MSPs, healthcare professionals and members of the public to sign up to become an antibiotic guardian via the website, antibioticguardian.com to ensure that current antibiotics continue to remain effective; further notes that it has been 30 years since a new class of antibiotics was last introduced despite growing numbers of infections becoming resistant to current antibiotics; notes calls for governments, academic research communities, pharmaceutical companies and other stakeholders to work collaboratively to develop a new funding model to incentivise the development and appropriate use of new antibiotics, and wishes the Royal Pharmaceutical Society in Scotland every success in its future efforts in dealing with this challenge.
12:33
I am grateful to colleagues in all parties who have supported the motion in my name and I welcome the opportunity to open today’s debate on European antibiotic awareness day, which took place in November last year, and to pay tribute to the valuable work undertaken by the Royal Pharmaceutical Society in raising awareness of the issue of antimicrobial resistance. The issue is important not just for individuals but for healthcare professionals and society as a whole, presenting, as it does, a major global health challenge.
Antimicrobial medicines include antibiotics and antifungal and antiviral treatments. Resistance arises through naturally occurring mutations. Overuse and misuse of antibiotics is thought to be a major cause of resistance, and that is facilitated in many countries by their availability to be bought over the counter without prescription. However, even where that is not the case, as in the United Kingdom, prescribing practices vary immensely.
Not completing antibiotics courses and prescribing doses that are too low, or prescribing for too short a period of time, allow stronger and more virulent bacteria to flourish and encourage the development of resistance. Resistance to antifungal and antiviral medicines is now also beginning to appear.
None of us should be in any doubt about the scale of the problem. The global impact of antibiotic resistance must not be underestimated; its effect on human health has been compared to the effect of climate change on human health. The emergence of infections that are resistant to drug treatment is a growing public health problem. If antibiotics are not used responsibly, we could face a situation in the future in which we simply do not have effective cures for infections.
In April 2014, the World Health Organization stated:
“Without urgent, coordinated action by many stakeholders, the world is headed for a post-antibiotic era, in which common infections and minor injuries which have been treatable for decades can once again kill”.
That is the scale of the problem that we face.
Across the European Union, 25,000 people a year die from infections that are caused by multidrug-resistant bacteria. It has been estimated that, by 2050, antimicrobial resistance will affect 10 million more people annually worldwide.
The inappropriate use of antibiotics can have serious public health risks. Antibiotics can disrupt the natural intestinal bacteria that we all have and allow organisms such as Clostridium difficile to flourish, with potentially severe consequences for patients.
Without effective antibiotics, many routine treatments will become increasingly dangerous. Setting broken bones, basic operations and even chemotherapy rely on access to antibiotics that work, and many procedures that currently allow people to live active lives for longer, such as hip operations, might become too risky to undertake. Organ transplantation would be severely compromised without the ability to treat secondary infections.
The World Health Organization estimates that the average human lifespan is extended by 20 years through the use of antimicrobials. Between 2000 and 2010, the global consumption of antibiotics in human medicine rose by nearly 40 per cent. Over the past 30 years, a new infectious disease has been discovered almost every year, whereas only two new classes of antibiotics have been introduced.
For a variety of reasons, antimicrobials are difficult to develop. Potential treatments can be difficult to formulate as medicines and can be expensive because of the cost of individual clinical trials for each therapeutic area in which the antimicrobial will be used. Furthermore, there is little incentive for pharmaceutical companies to develop medicines that are used for only short periods of time to treat and cure infections.
In November last year, I was pleased to host a seminar in Parliament on behalf of the Royal Pharmaceutical Society in which the Scottish Government’s healthcare associated infection medical adviser, Professor Alistair Leonard, outlined the Scottish Government’s strategic objectives in the area. They are to improve the knowledge and understanding of antimicrobial resistance; to conserve the effectiveness of existing treatments; and to stimulate the development of new antibiotics, diagnostics and novel therapies.
The Royal Pharmaceutical Society recently published a scientific guide entitled “New Medicines, Better Medicines, Better Use of Medicines”, which recommends educating the public and patients on the use of antibiotics and their place in therapy; encouraging further development of antimicrobial stewardship by healthcare professionals to maintain the effectiveness of current and any future antimicrobials; and supporting the discovery and development of new antimicrobials or treatment methods by developing new financial incentives.
Antimicrobial stewardship means prescribing appropriately and conserving the antibiotics that we currently have using the evidence-based guidelines that have been developed by specialist teams. Only today, the recommendations of the review on antimicrobial resistance, which was chaired by the economist Jim O’Neill, were published in “Tackling a global health crisis: initial steps”. That United Kingdom-wide initiative has attracted a range of clinical and technical input, including from Professor Mark Woolhouse, who is professor of infectious disease epidemiology at the University of Edinburgh. Among the recommendations are the setting up of a global innovation fund of around $2 billion and the training of a new generation of scientists in that field of study.
New approaches to developing antimicrobials are urgently required to make that more attractive and to promote innovative research, such as on therapies to boost immune systems and on using specific viruses that kill bacteria without producing resistance or damaging human cells. Scotland is well placed to encourage that type of research and to work with industry to develop better and safer medicines through innovative research.
We must reduce prescribing to the lowest and safest levels. I am thinking of the need to minimise the overuse of broad-spectrum antibiotics. In secondary care, prescribers should review prescriptions daily and should consider whether antibiotics can be safely stopped or changed from a broad-spectrum antibiotic to a narrow-spectrum antibiotic, which has less potential to allow resistant Clostridium difficile infections to develop, thus improving patient safety in hospitals.
Success depends on sustainable change. More awareness is needed among patients and the public about the seriousness of the challenges that we face if we are not to return to an era in which infections are untreatable.
All healthcare professionals must work in partnership with their patients to discuss when antibiotics are necessary and when they are not required. Healthcare professionals are ideally placed to point out the alternatives that may be available, and pharmacists have a specific role to play in that regard. Specialist pharmacists play a leading role in stewardship to ensure the appropriate prescribing of antibiotics as part of a multidisciplinary approach through the Scottish antimicrobial prescribing group. Much has already been achieved by antimicrobial pharmacists, working with national health service board antimicrobial management teams, to influence hospital prescribing.
The Scottish Government, Healthcare Improvement Scotland, Community Pharmacy Scotland and the Royal Pharmaceutical Society supported European antibiotic awareness day with a resource pack comprising a poster, patient information leaflets and self-care information sheets, which were distributed to all community pharmacies in Scotland. In addition, a self-care guide from the Royal College of General Practitioners has now been adapted for use by community pharmacies. The guide is designed to manage patients’ expectations of illness duration and highlights potentially serious symptoms that warrant further review.
Only through Governments, academic research communities, pharmaceutical companies and other stakeholders working together in Scotland, across the UK and internationally will we raise awareness of this important issue and develop the new funding models that are necessary to incentivise the development and appropriate use of new antibiotics. In doing so, we will be saving and improving the lives of millions of people, not just here in Scotland but across the world. What better endeavour could there be than that?
12:42
I congratulate Jim Eadie on securing this important debate.
The World Health Organization estimates that the average human life has been extended by 20 years through the use of antimicrobial agents. We now know, however, that they are a major potential threat to public health and patient safety. The central message of European antibiotic awareness day, which is mentioned in the motion, is that antibiotics must be used responsibly to preserve their effectiveness for future generations.
The central scientific fact underlying all this concerns naturally occurring mutations resulting in antimicrobial resistance. Bypassing scientific language, the message has to be that we must not misuse or overuse antibiotics. On overuse, I am told that 55,000 people take antibiotics every day in Scotland and that up to 50 per cent of them are for conditions that would get better without them.
I am also told that a European survey has indicated that 52 per cent of people in the UK do not realise that antibiotics are ineffective against viruses. The percentage is even higher in other European countries. That is an alarming statistic. The first task, clearly, is to educate the public not to demand antibiotics when they are not required. We will come on to the responsibilities of health professionals in a moment.
A further issue is that, when antibiotics are prescribed to patients, they must complete the course, otherwise stronger bacteria are encouraged to flourish. As is alluded to in the motion, MSPs have a role in publicising some of that. The motion refers to antibioticguardian.com, which I have visited. Others in the chamber may have done so, too. I hope that all MSPs will visit the site, make their own pledge about not overusing antibiotics and put that post on their Twitter and Facebook pages, as I have done today.
Health professionals have an equal if not greater responsibility in all of this. I was interested to read again the antimicrobial resistance strategy and social action plan from 2002, when I was Minister for Health and Community Care. Among other things, the strategy referred to the importance of “Prudent Antimicrobial use” and to the need for greater coverage of that in the undergraduate and postgraduate medical curricula.
I think that there has been some progress. Figures for last year show that there have been as many as 276,000 fewer antibiotic prescriptions in primary care, so I imagine that that is progress, but I have been surprised to read of the extent of the problem in secondary care. “The Scottish Management of Antimicrobial Resistance Action Plan 2008” says:
“It is known that a significant proportion of current antimicrobial usage in hospitals is not ‘prudent’”.
Again, that could be due to excessive or inappropriate use.
Jim Eadie gave the example of Clostridium difficile: the point is that if a broad-spectrum rather than a narrow-spectrum antibiotic is used, it can destroy benign bacteria in the gut and encourage the development of C difficile. Also, of course, we all know about MRSA, which operates in a related way. The public are very aware of those superbugs, but they might not be aware of the relationship between those superbugs and the inappropriate use of antibiotics.
I must mention, as Jim Eadie did, the Royal Pharmaceutical Society, for its work in general and for the guide that Jim Eadie referred to in particular. Jim Eadie also highlighted the three main points in the “New Medicines, Better Medicines, Better Use of Medicines” guide. I will not repeat the words but clearly much of it is to do with educating the public and health professionals.
The final point that the RPS emphasises is the importance of supporting the discovery and development of new antimicrobial agents; the RPS also talks about developing new financial incentives for that. I am not entirely clear about what that might involve but it is a striking fact that so few antibiotics have been developed over the past few decades. There are financial reasons for that—people only take antibiotics for a short time and so on, so it might not be the most attractive investment for pharmaceutical companies—but that aspect of the subject is also one that we should remember today.
I thank Jim Eadie once again for introducing the debate and I hope that all MSPs will do what they can to promote awareness of this important issue.
12:47
I thank Jim Eadie for highlighting the vital role that the Royal Pharmaceutical Society plays in Scotland and also for raising our awareness of European antibiotic awareness day. I commend this annual awareness day, now in its seventh year, which is marked on 18 November. The key message from the initiative is worthy of repetition—namely, that antibiotics must be used responsibly to preserve their effectiveness, not just for people now but for the generations that follow.
The various leaflets and posters that are produced highlight the simple fact that common infections such as coughs, colds, sore throats and earache should not be treated initially by the use of antibiotics. Indeed, despite the fact that antibiotic prescribing for those conditions rose by 40 per cent between 1999 and 2011, antibiotics were effective in only about 10 per cent of cases. Coming from a medical background and having a husband who is a retired general practitioner, I am all too aware that there are instances in which prescribing medicines for such conditions seems to be the “easy” option, but that culture has to change.
NHS Scotland has supported other UK-wide activities on 18 November, such as the antibiotic guardian campaign, which is a grass-roots initiative that asks people from the healthcare professions and ordinary members of the public to read up on the facts and figures regarding antibiotics and to share that information with others. It is alarming that 25,000 people across Europe die each year as a result of infections that have become resistant to antibiotics. That is one of the biggest threats facing us today, as Jim Eadie indicated, and is caused by bacteria fighting back against antibiotics.
Community Pharmacy Scotland has supported the campaign with the promotion of resource packs to its 1,250 community pharmacies throughout Scotland, giving invaluable advice on where and when antibiotics should be used and letting people know that pharmacies often have a dedicated healthcare team who can advise on the right type of treatment for minor ailments without necessarily resorting to the use of antibiotics.
Community Pharmacy Scotland also plays a pivotal role in the Scottish antimicrobial prescribing group—SAPG—which acts as the umbrella organisation for pharmaceutical healthcare in Scotland, bringing together other bodies such as the RPS in Scotland and Pharmacy Voice. That joined-up approach helps to foster greater understanding of the use of antibiotics by healthcare professionals, and I was pleased to read that there has been a significant decrease in their unnecessary prescribing in the past two years. I endorse the general ethos of SAPG, which is making the best use of antimicrobials to manage infection so as to ensure optimal outcomes and minimal harm to patients and wider society.
Although there are approximately 160 varieties of antibiotics available in seven different categories, one of the problems is the difference between broad-spectrum and narrow-spectrum antimicrobials—the former covering all manner of infections and the latter targeted at specific bacteria—and the importance of using the right drug for a specific infection. The rapid spread of multidrug-resistant bacteria brings us closer to the point at which we might not be able to prevent or treat everyday infections or diseases, which would have a devastating impact, as Jim Eadie said. It would make routine procedures such as setting bones, hip replacement, heart surgery and even chemotherapy dangerous, because all those procedures rely on effective drugs to prevent or treat infection.
Worryingly, only a handful of pharmaceutical companies now invest in antibiotic development, which has resulted in a call for all stakeholders to work together to develop a new funding model to incentivise the development and appropriate use of new products. One such drug that was brought to my attention just last week is the narrow-spectrum drug fidaxomicin, which I understand is the first in its class to be introduced in the past 50 years. It has been approved for use against C diff in adults and has already benefited nearly 14,000 patients across Europe and more than 4,000 in the UK. The development of such narrow-spectrum drugs that are effective against specific organisms would make a significant contribution to combating antimicrobial resistance; hence the need to incentivise the development of new products.
Time precludes me from saying more, so I will close by reiterating my thanks to Jim Eadie for alerting us to the urgent need to combat antimicrobial resistance if we are not to return to an era in which infections are untreatable, as they were in the dark ages of my very early childhood before antibiotics were available.
12:52
Like others, I thank Jim Eadie for bringing a debate on such an important subject to the chamber today.
Moving on to a history lesson, in 1877 Louis Pasteur was the first to observe that some types of bacteria obstruct the growth of others. However, it was not until the great Ayrshire biologist, pharmacologist and botanist, Sir Alexander Fleming, returned from holiday in September 1928 to find his Petri dish contaminated with a strange mould that significant progress was made. It was as if the mould had secreted something that inhibited bacterial growth. It transpired, of course, that he had found Penicillium notatum. That discovery created a revolution in the treatment of infections that enabled the successful treatment and prevention of many illnesses that had previously been virtually untreatable. As we know, as a result of his endeavours Fleming went on to be jointly awarded the Nobel prize in physiology and medicine in 1945.
One of penicillin’s great successes was in treating trauma injuries and illnesses sustained by soldiers during the second world war. In many of those cases, penicillin stopped what previously would have been an almost certain decline to gangrenous wounds and inevitable amputational septicaemia, at the very least, which can be fatal. As a result of that experience, penicillin was subsequently used to treat a multitude of infections. Even for people unfortunate enough to have an allergy, there was the development in due course of erythromycin and other non-penicillin-based antibiotics, for which many in my family have a great deal of use.
Progress has been substantial, and a very good example of that has to be tuberculosis. At one time, TB threatened the masses, but as a direct result of antibiotics and an inoculation programme it has been virtually eradicated, at least in the western world. However, there has recently been an upsurge of TB in the world’s population, which is partly due to overenthusiasm for the use of antibiotics and their inappropriate and incorrect use at times. It cannot escape the attention of anyone that it is becoming increasingly the case that conditions that were previously successfully treated are no longer so successfully treated.
For the science enthusiasts among members, there can be no better micro example of the process of evolution than the development of bacterial resistance: antibiotics attack the offending bacterial infection and brilliantly defeat the dominant bacteria, but that leaves other bacterium that were previously outcompeted; despite their previous weaknesses, the remaining bacteria are unaffected by the antibiotic and become dominant, so they are not only resistant to the treatment but have no bacterial competitor—hence superbugs. Natural selection—survival of the fittest—has left us with ever evolving strains of bacteria, such as MRSA. We were warned of that, of course: Sir Alexander Fleming spoke of the dangers of resistance in his Nobel prize speech back in 1945.
Where do we go from here? One way is to continue to evolve drugs, not quite outcompeting but at least reacting to a changing common enemy. However, developments in new antibiotics have been few and far between, apart from the recent discovery by a US scientist, published in the journal Nature, which has been described as a game changer, with experts believing that the antibiotic haul is just the tip of the iceberg.
Raising standards of health in the population clearly creates a population that is less susceptible to infection, but there will always be people who are unfortunate enough to require medical attention, so we have to be particularly mindful of the elderly and sufferers of diseases—such as HIV and AIDS—that make them particularly susceptible to infection. Therefore, with others, I am pleased that the Scottish antimicrobial prescribing group has demonstrated an impact through the decrease of 6.5 per cent in prescriptions last year.
Jim Eadie has already referred to the World Health Organization report. Its opening was a bit more graphic:
“global surveillance of antimicrobial resistance reveals that antibiotic resistance is no longer a prediction for the future; it is happening right now, across the world, and is putting at risk the ability to treat common infections in the community and hospitals.”
We have a real problem, which the debate has done well to highlight. I thank Jim Eadie once again for bringing it to the chamber.
12:56
I reiterate thanks to Jim Eadie for bringing this important debate to the chamber and for describing antibiotic awareness day, which is important; the programme of signing up as antibiotic champions, which is an interesting development—we will see how it proceeds—and the work of the Royal Pharmaceutical Society and Community Pharmacy Scotland, to which Nanette Milne also referred.
On community pharmacy, in Scotland, we have a unique approach in the minor ailments scheme. It is currently restricted to those who were previously eligible for free prescriptions. That is a bureaucratic matter that the new health team needs to address, as it is regrettable.
When I was a student, we had major concerns about rheumatic heart disease arising from staphylococcal or, usually, streptococcal infection in the throat. Therefore, we used antibiotics. Sometimes, we sprayed them around the place. We now know that that was not a good course of action.
There is undoubtedly pressure from patients on general practitioners. We should recognise that general practitioners are under massive pressure and, therefore, it is difficult for them to take the time to explain to a patient that their condition is probably viral. They do not have diagnostic tests that they can apply on the spot. That is an area of research that we need to develop because, if we had such tests, we might be able to distinguish more readily between upper respiratory tract infections that are bacterial and require treatment to prevent rheumatic heart disease and infections that are viral.
General practitioners have made attempts to introduce methods such as delayed prescribing, in which they give the patient the prescription but ask them not to take it for two or three days and take it only if the condition worsens. There is some evidence that that is useful and helpful.
Roderick Campbell mentioned tuberculosis. The three traditional treatments for tuberculosis—streptomycin, para-aminosalicylate sodium and isoniazid—have been a great advance, but we now have resistant tuberculosis. The minister is probably aware that I have asked a number of questions about the development of techniques to ensure that TB does not become a significant problem among certain populations, such as the homeless and some refugees who come from very difficult situations into our country. We need to ensure that that situation is taken care of.
Tuberculosis is something that every student who entered university used to be X-rayed for at the beginning of their course. I am not in any way advocating a return to such global screening, but we need to keep a close watch on the issue. We debated it as part of our consideration of the Public Health etc (Scotland) Bill in the previous parliamentary session. In South Africa, people with resistant TB are locked up until their treatment has been successful, and that is sometimes extremely difficult.
We live in an era in which it is recognised that antimicrobial resistance is extremely important. Anything that the Government can do by way of publicity, as part of its winter resilience programme, to advocate the non-use of antibiotics would be welcome.
Jim Eadie and others mentioned specialist pharmacists, who have played an enormous role in the hospital setting in ensuring that junior doctors do not misuse antibiotics. The reduction in the use of broad spectrum antibiotics has contributed to the significant reduction in the number of cases of C difficile, which the Government should be applauded for. However, we are now falling behind England in what we are achieving on C difficile. Fidaxomicin, which was approved by the Scottish Medicines Consortium, has only just gone on to the protocols of many hospitals. We are considerably behind England in its use—Public Health England, the equivalent of Health Protection Scotland, issued guidance on that 18 months ago, whereas HPS did so only three months ago. We cannot continue to be behind other countries.
I have two brief final points. First, there is a whole new science around what is called the microbiome. Every one of us has billions of bacteria in our gut. The good bacteria are absolutely essential to our liver. We live in a symbiotic relationship with the bacteria in our gut. We treat them with disrespect at our peril, because that can lead to all sorts of problems.
My final concern is about an area on which it is not for the Minister for Public Health to reply. It relates to the use of antibiotics in veterinary medicine, which we need to look at very carefully. Fifty years after the Swann report, that is still a significant issue.
13:02
I, too, congratulate Jim Eadie on securing the debate and setting out the stark situation. I welcome the work that the Royal Pharmaceutical Society in Scotland and the Scottish antimicrobial prescribing group are doing to heighten awareness, and I thank all the members who participated in the debate, and whose contributions ranged from Rod Campbell’s history lesson to Nanette Milne’s and Richard Simpson’s sharing of their professional knowledge of the subject.
In 2008, this Government recognised the importance of raising awareness of resistance to antibiotics and the need for specific actions and advice to provide all healthcare professionals and the public with information on what we need to do to prevent an increase in such resistance. That is why we set up SAPG, which is a national clinical multidisciplinary forum.
European antibiotic awareness day is a major public health initiative that has been held annually since 2008. It aims to encourage responsible use of antibiotics and to tackle the global issue of resistance to them. I commend the contribution of the Royal Pharmaceutical Society in Scotland to the EAAD campaign. It has supported EAAD from the outset through the media and communications to pharmacists, and for the past two years it has been greatly involved in planning the Scottish activities.
During the 2014 campaign, RPS Scotland, in partnership with the Scottish Government, SAPG and Community Pharmacy Scotland, was central to our self-care leaflets initiative. Those leaflets support pharmacists in providing patients with specific advice about symptoms of respiratory illness, as well as facilitating referral to a GP if required. Their primary aim is to promote community pharmacies as the first port of call for advice and treatment for winter illnesses, which are typically caused by viruses, and to reduce patient expectations of receiving antibiotics as the first line of treatment. That approach has attracted interest from Public Health England, which is looking to replicate it.
Each year, SAPG organises distribution of EAAD support packages to each NHS board. Those are tailored and disseminated to hospitals, GP practices, care homes and other healthcare providers. Community pharmacies receive their packs as part of their year-round support for national public health campaigns.
As Jim Eadie highlighted, an important component of that annual campaign is the antibiotic guardian initiative. Anyone can sign up to be a guardian—I am pleased that Malcolm Chisholm has done so—from healthcare professionals, veterinarians and farmers to members of the public. SAPG promotes sign-up to the initiative and all communications about EAAD. Many staff who work in antimicrobial stewardship have used the antibiotic guardian logo signature strip to promote the initiative.
To date more than 12,000 people have signed up across the UK. On signing up, the guardian chooses an action pledge to support the overarching aim, which is to ensure that antibiotics work now and in the future. Public Health England will shortly be sending an evaluation questionnaire to all guardians who have consented to follow-up. That will help to measure, and to confirm, whether guardian pledges were kept.
Planning for the 2015 campaign will commence in the spring; I encourage members to play their part locally in raising awareness. What better way is there to do that than to become an antibiotic guardian?
As has been mentioned, since 2008 infection, prevention and quality improvement teams have achieved a significant reduction in C difficile rates and in prescribing of high-risk antibiotics through the introduction of local and national prescribing indicators. The latest SAPG annual report, which was published in January this year, shows that there was a 5.4 per cent decrease in the number of prescriptions for antibacterials in primary care GP practices. Also, the use of broad-spectrum antibacterials associated with higher risk of C diff was reduced by 12.7 per cent in primary care settings.
Those figures are encouraging; however, further work linking C diff cases with morbidity and mortality, and prescribing data is being carried out to help our understanding of the epidemiology of disease in the community and to identify areas for further reduction measures.
As members who have taken part in the debate have mentioned, resistance to antimicrobials continues to pose a serious public health threat globally. The loss of effective antimicrobials undermines our ability to fight infectious diseases and to manage the infectious complications that are common in vulnerable patients. A key challenge is the fact that few new antimicrobials have been developed.
A key area of work in the effort to tackle the threat of global antimicrobial resistance was the setting up of a UK five-year AMR strategy, which was launched in September 2013. The UK and Sweden led the development and adoption of a new World Health Organization resolution on AMR, which provided a mandate for the development of a WHO-led global action plan by May 2015. Through the UK strategy, we are working with the WHO and member states to develop the plan, which will take the “one health” approach. This Government works closely with the UK Government and the other devolved administrations to drive forward that work, which is aimed at slowing the development and spread of antimicrobial resistance. The first annual report, which was published in December 2014, showed that good progress had been made.
The Scottish Government is fully committed to supporting that strategy and related initiatives in order to maintain focus on, and pace in, achieving further reductions in healthcare-associated infections, and to ensure appropriate antibiotic prescribing and vigilance against resistance to antibiotics. To tie in with that work, the Government, through the Scottish HAI task force, set up an expert group on controlling antimicrobial resistance in Scotland—CARS for short—which is chaired by the Scottish Government’s chief medical officer. The purpose of the group is to oversee Scotland’s antimicrobial resistance strategy and to support delivery of the UK AMR strategy. CARS will build on and maintain the momentum that has been generated by the Scottish management of antimicrobial resistance action plan, version 2 of which was published last July and which is available at the back of the chamber. CARS will produce a delivery plan that focuses on the seven key areas of the UK strategy. It will develop outcome measures and publish an annual report on progress that aligns with the UK strategy.
In NHS Scotland, in 2015-16, an AMR public awareness campaign will be developed and delivered by NHS Health Scotland, with input from other key agencies. The Government is committed to supporting that important work through the Scottish HAI task force.
Scotland has established itself as a leader in antimicrobial stewardship and is recognised worldwide as having an exemplar antimicrobial stewardship programme. Through the work of organisations such as the RPS, the SAPG and other key stakeholders, huge inroads have been made in ensuring adherence to local prescribing guidelines in hospital and primary care settings. However, continued efforts are required to sustain that and to improve the situation further. I thank Jim Eadie for bringing the debate to the chamber.
13:11 Meeting suspended.