The Importance of Data
If we are to win the battle with antimicrobial resistance (AMR), we need to understand it as well as we possibly can, that is why it is so important to collect and share data.
We need data on four key areas:
- resistance to antimicrobial medicines
- the burden of disease associated with AMR
- trends in the use of antimicrobial medicines
- the quality of antimicrobial medicines
This data has two primary purposes:
- enabling better decisions today
- enabling local, national and global trend monitoring, to assess the impact of changes to policies or working practices
Read on to discover why each data area is so important and some of the things the Fleming Fund is doing to help.
Data on resistance to antimicrobial medicines ▾
Over time, infectious diseases build up resistance to antimicrobial medicines such as antibiotics. To ensure the medicines we use in healthcare continue to have the desired effect we need to understand which infections are resistant to which antimicrobial medicines. This enables clinicians to choose the most appropriate drug in each situation. It reduces the time a patient is suffering and enables us to preserve our broader spectrum antibiotics for when we really need them.
As well as understanding how resistant a particular pathogen is to a given antimicrobial, it is important we build up a picture of the total cases of resistance; for example, the number of occurrences of drug resistant bacteria in a given country.
The World Health Organization (WHO) brings together global AMR data from different countries in its Global Antimicrobial Resistance Surveillance System (GLASS). The Fleming Fund is helping increase the amount of data uploaded to GLASS by supporting projects that will improve laboratory surveillance capabilities and that share data with the WHO system.
Data on the burden of disease associated with antimicrobial resistance ▾
It is essential that decision makers understand the nature of the health and economic consequences that arise when antimicrobial medicines are no longer effective in treating infections.
In the human context, increased AMR could mean greater numbers of people who die from common infections, who live longer with severe illnesses or who suffer with long term disabilities.
There could also be higher treatment costs incurred in the longer treatment required or longer hospital stays, as well as the wider impact on a country’s economy resulting from lost productivity.
On the agricultural side, the consequences of AMR could be anything from reduced revenues for farmers to global food shortages.
Understanding these broader impacts and their severity enables better decision making, both locally and nationally. Locally, a hospital manager, by understanding the human and financial cost of AMR in their facility, will be able to make better operational decisions, such as ensuring clinicians are using the right antibiotics. A health minister, for example, needs to understand what policies to put in place and where best to allocate scarce funds. And a farmer would see that extensive use of antibiotics threatens their livelihood in the longer term, when antibiotics become an ineffective treatment when they are needed.
The Global Burden of Disease study is modelling and mapping the effect of hundreds of diseases all around the world. A grant from the Fleming Fund is ensuring that morbidity and mortality associated with AMR is represented on this study.
Data on trends in the use of antimicrobial medicines ▾
The Fleming Fund supports the WHO and World Organisation for Animal Health projects to help countries understand and track the scale of antimicrobial consumption and use in human and animal health.
High use of antimicrobial medicines, both in humans and animals, leads to increased resistance to these drugs. It is therefore essential that unnecessary or inappropriate use of antimicrobial medicines is reduced.
To do this, health authorities need data to show where both the use of antimicrobial medicines and resistance to these medicines is particularly high. This will help identify where usage could be cut, and enable monitoring that shows whether a reduction in consumption leads to a reduction in resistance and/or an increase in disease.
Equally, at a local level, a hospital needs to understand where antibiotics are being used and what they are being used for. These insights enable better decision making and ultimately better quality care.
The Fleming Fund supports the WHO and World Organisation for Animal Health (OIE) projects to help countries track the scale of antimicrobial usage in humans and animals. You can read more about the surveillance of antimicrobial use on the WHO website.
Data on the quality of antimicrobial medicines ▾
A large number of antimicrobial medicines in Africa and Asia are sub-standard or falsified and will likely be ineffective in treating disease. These medicines contribute to growing trends in resistance and undermine our ability to treat a condition effectively.
Ultimately, both in human healthcare and agriculture, we want to use medicines that are effective in treating each infection and condition. If an antimicrobial medicines does not work as expected, we need to understand if this is because of antimicrobial resistance or if the medicines itself is poor quality.
Low quality medicines are a huge problem, particularly in Africa. As well as failing to improve the patient’s or animal’s health, their use contributes to growing resistance to the drugs.
Health authorities need to be able to identify where falsified or low quality drugs are being used, so they can be removed from circulation as quickly as possible, both in their own countries and elsewhere.
The Fleming Fund supports country level investigation of low quality antibiotics, to ensure cases are logged on the Global Surveillance and Monitoring System (GSMS), the WHO’s central database of information about substandard and falsified (SF) medical products.