This is a theme and not a programme.
Bacteria that outsmart medicines developed by humans: antibiotic resistance is an urgent and global problem. A problem that requires a multidisciplinary international approach. Edith Schippers, Dutch Minister of Health, Welfare and Sport, devotes extra attention to antibiotic resistance in 2016, during the Netherlands’ Presidency of the EU. ZonMw runs several programmes on this issue.
Doctors with no means to treat seriously ill patients. This nightmare scenario will become a reality if we do not succeed in halting bacterial resistance to antibiotics.
The rise of antimicrobial resistance is the result of a number of developments – developments that are in fact mutually reinforcing. Demographic ageing and the increase in the number of chronically ill people means more people are vulnerable to infection. At the same time, bacteria are becoming smarter. So we need new antibiotics. But development of new antibiotics is stagnating because doctors have become more cautious about prescribing them, so there is less incentive for manufacturers to develop new products.
Information on the research areas of the Antibiotic Resistance Programme
The situation is not yet alarming in the Netherlands. We have a good general state of health, good healthcare and a responsible antibiotics policy. Our resistance problem is therefore relatively small. But the Netherlands is not an island: we have open borders. And some of our antibiotic resistance problem is imported from elsewhere. People who travel to distant destinations run the risk of bringing drug-resistant bacteria back to the Netherlands. In many countries, particularly in Southeast Asia, the resistance problem is much greater. Doctors there are much more liberal in their use of antibiotics than in the Netherlands. In some countries, antibiotics can in fact be purchased over the counter.
The Netherlands is keen to resolve the antimicrobial resistance problem. Edith Schippers, Minister of Health, Welfare and Sport, and Sharon Dijksma, State Secretary for Economic Affairs and Agriculture, chaired a WHO conference on the issue in The Hague in June 2014, at which 40 countries agreed to tackle the problem. Initiatives are also being undertaken at European level. There is for example a Joint Programming Initiative (JPI) on antibiotic resistance. A JPI is a research initiative in which member states collaborate on a particular theme, with the support of the European Union. A strategic research agenda has been compiled for this JPI, listing subjects that are roughly the same as those in ZonMw’s AMR programme: development of new antibiotics, diagnostics, transmission, interventions and surveillance. International initiatives like this help ensure that scarce research resources are used as efficiently as possible.
Hospital patients requiring invasive treatments will be the first to feel the impact of growing antimicrobial resistance. Patients who develop bedsores after a major operation will have to be discharged earlier, for example. Doctors will not want to risk them developing a hospital infection. But healthy young people may also be affected by the consequences of antibiotics resistance. In India there are TB patients for whom no antibiotics work. Such problems might occur in the Netherlands among people who come other parts of the world, or who have spent a long time there.
ZonMw collaborates with a number of organisations, both nationally and internationally, to reduce the problem of antimicrobial resistance: