As if climate change, international terrorism, rising mental ill-health, teenage knife crime, post-Brexit instability and potential superpower tensions were not enough to worry the heck out of us parents, the real spectre of a post-antibiotic era looms. Will my children live as long as I? Will I live as long as my parents or die a lingering death from an untreatable infection picked up in a nursing home which functioned as a reservoir of antibiotic resistance? In 2013 England’s Chief Medical Officer considered the rise in antimicrobial resistance “a national civil emergency”1. In May 2016, the O’Neill “Review on Antimicrobial Resistance (AMR)”2, sponsored by Welcome Trust and the English Department of Health, produced a plan for tackling drug-resistance globally exactly one year after the 68th World Health Assembly endorsed the WHO’s global action plan for AMR3. Both plans highlighted “strengthening of knowledge through research”.
For those of us with enough miles on our biological clocks, this sounds very familiar. 1998 seemed to be a year signaling a paradigm shift in health priorities with the publication of reports like “The Path of Least Resistance”4 and the European Union’s urgent convocation of the Copenhagen Summit on “The Microbial Threat”5. Both highlighted the need for better research to develop a robust evidence base to inform practice and policy. Twenty years on we appear to stand at the edge of the abyss. Yet it would not be fair to say that in the interim there has been no change.