Joining forces to fight drug-resistant pathogens

We need a truly multidisciplinary approach to deal with this creeping and significant threat to human, animal and plant life.

I’ve been working for UK Research and Innovation (UKRI) for a long time, including for the predecessor organisations of Biotechnology and Biological Sciences Research Council (BBSRC) before its formation in 1994.

I remember well Tom Blundell, the inspirational leader of the Agricultural and Food Research Council, where I was working at the time.
He was a very outward-looking individual and had a broad view of what he wanted bioscience to achieve when we formed BBSRC.

He wasn’t hung up on disciplines. It didn’t matter if it involved chemistry or engineering. In other words, he had his eye on the prize and believed that if your ideas were good enough you would achieve that prize.

I feel that we have still not quite realised his vision. Many people have a fairly closed vision of what bioscience is all about and do not appreciate how the integration with other disciplines is critical to achieving impact.

Bioscience alone will not counter resistance

What is clear to me and many others is that bioscience alone will not be enough to counter one of the biggest threats to human, animal and plant life.

Antimicrobial resistance is often described as a slow pandemic. It is the emergence of resistance to antibiotics in bacteria, fungi and other microbes. Ten million people a year are expected to lose their lives to it by 2050.

The methods we currently use to prevent the emergence of or to control resistant pathogens are not working. In some cases, they thrive in the circumstances that you try to treat them.

Resistance is a growing problem, and we may have no way to treat it in the future. The use of antibiotics is routine in hospital operations but what happens if those antibiotics become ineffective?

How do you prevent a cut on your finger not resulting in death if you are unable to control infections?

We understand resistance but struggle to prevent or control it

That’s one of the key reasons why UKRI is focusing on tackling infections, as one of the five, biggest existential threats to us all.

We have a good grasp of the mechanisms of antimicrobial resistance, how transmission happens between organisms, what mechanisms affect resistance and what conditions allow it to happen.

Despite this deep and important knowledge, we have not been able to make significant strides forward in preventing or controlling antimicrobial resistance.

One of the earliest things I learned in bioscience was that working out how an organism acquires the capacity to overcome an antibiotic is not enough. There are a whole lot of other things that need to happen or to be in place for you to use that knowledge effectively.

Diverse perspectives deliver more robust solutions

If you put together a group of people who see a problem from different perspectives, the likelihood is you will have solutions that are more practical and robust in the real world.

We recently supported some community building work in industrial biotechnology, in which academics and businesses working in manufacturing natural products got heavily involved.

They found that some natural products produced by different parts of plants, by seaweed or by microorganisms were potentially of use in antimicrobial resistance.

The results of this work and particularly bringing together the different expertise have helped to inspire the multidisciplinary approach we are now taking to antimicrobial resistance.

We need multidisciplinary networks

Through UKRI’s tackling infections funding and thinking we are supporting the establishment of new networks that bring together bio-scientists with social scientists, environmental scientists, agriculturalists, engineers, technologists and designers and those working in the humanities. We need to think of future ways to prevent or treat resistance that doesn’t always involve drugs.

This approach is being supported across UKRI by my colleagues in biomedicine, social sciences, humanities, engineering and physical sciences and environmental science, allowing us to deploy the full range of disciplines on this critical problem.

For example, antimicrobial agents are used in agriculture to control infections and they have also been used as growth promoters. You can only imagine what happens if this leads to resistant pathogens in the food chain and people become affected when food is not prepared properly.

A lot of what happens on farms is about behaviour and cultural norms. We have been involved in a collaborative project in Argentina that is looking at ways of restricting antibiotic use on farms and reducing their prevalence in the food chain. Understanding farmers’ attitudes to antibiotics and how they behave with them has been critical to the success of that work.

What things are we missing?

We need designers, technologists and engineers to look at how you design and control processes in diverse ways such as infection control in hospitals as well as the disposal of farm waste.

Wherever there’s a piece of technology or design or an environment, how do you optimise it to prevent or reduce infection?

In putting these multidisciplinary communities together, we want to see involvement from researchers and businesses working across disciplines and boundaries. We are planning to make future investments in research and innovation activities that come out of this work or are inspired by it.

Next five years is critical

It’s about building some insurance against this slow pandemic. I hope it will put the UK in a far better position than today in not only understanding what resistance looks like but how you might prevent it in the first place or treat it more effectively. These approaches may well be applicable to other nations too. Resistant microbes do not recognise international borders.

We know it won’t be done by bioscience alone. This is our big opportunity to find solutions. What happens in the next five years will be absolutely critical.

Top image:  Credit: UKRI

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