Geneva, Switzerland//- Marking World Antimicrobial Awareness Week on 18-24 November, the Union for International Cancer Control (UICC) has emphasised the danger that drug resistance poses to individuals who are particular vulnerable to infection, such as people living with cancer, with fatal infections representing a significant cause of death among cancer patients.
There has been substantial progress in cancer care in the past decades, with key advances in surgery, radiotherapy and medicines, including newer immunotherapies. This progress is being undermined by the growing resistance of bacteria to the antibiotics and other antimicrobial medicines designed to kill them.
People with cancer are more susceptible to infections due to the cancer itself, and because surgery and cancer treatments such as bone marrow transplants, radiotherapy and chemotherapy put the immune system under immense pressure.
As many as 1 in 5 cancer patients undergoing treatment are hospitalised due to infection or infectious disease such as pneumonia. 1 in 10 people living with cancer die from severe sepsis – not from the cancer itself.
“Effective antibiotics are essential if we wish to see people with cancer complete their treatment successfully and survive. Many patients simply have to take them – and the world owes it to them to better manage our use of the drugs, avoid over prescription and use in farm animals, improve infection prevention and control, and support the research and development of new medicines. We need urgently to address this crisis, which could roll back progress made to date in cancer care.” – Prof. Jeff Dunn, AO, President of UICC
Starting in 2019, UICC set up a taskforce that combined experts from the cancer and infectious diseases communities. The taskforce selected three areas in which to focus their efforts and make policy asks to address antimicrobial resistance (AMR): collect reliable data on the impact of resistant infections on cancer patients; ensure the availability, affordability and sustained access to quality assured antimicrobial medicines and improve diagnostics capability; integrate AMR control into national cancer control plans with adequate funding.
At the World Cancer Congress, UICC presented a wide-ranging report on the impact of AMR on cancer care outcomes – and what can be done about it.
Produced by the AMR taskforce and written by over 50 experts committed to researching the scale of AMR and finding workable solutions, the report issues a series of recommendations, including:
- Improve public awareness: The message that AMR concerns everyone must be conveyed widely to limit the misuse of certain drugs.
- Create visibility. As the COVID-19 pandemic illustrated perfectly, when numbers are reported daily, and everybody acknowledges the threat, powerful action follows.
- Engage the health workforce. Health-care personnel have an active role to play in drawing attention to AMR, ensuring the appropriate use of medicines and strong infection control practice in medical settings, as well as providing key input to national policy on AMR.
- Address over prescription. There needs to be stronger regulatory mechanisms to address over-the-counter sales of antimicrobials (including antibiotics), and to share best practices and encourage training among the healthcare community to ensure appropriate and prudent use of these medicines.
- Ensure access to diagnostics and treatment
- Encourage the development of new medicines. As successful antimicrobials are destined to be replaced and to be successful, they must be used sparingly, innovative funding initiatives and reimbursement models for new medicines are needed, for example de-linking reimbursement from volume and paying instead based on social value. These concepts have been put into place now in the United Kingdom and have been endorsed by the G7 Health Ministers in 2022.
- Design a centralised and specialised surveillance system for people with cancer to predict and prevent the emergence of antibiotic resistance. Finding better ways to predict, prevent, and treat antibiotic-resistant infections will have a major positive impact on the care of those with cancer.
- Strengthen infection prevention and control (IPC)