Barbara Fallowfield
Managing Director, British In Vitro Diagnostics Association (BIVDA)
A multifaceted approach is needed to tackle antimicrobial resistance, and accurate diagnostics have a vital role to play in containing the problem and finding a solution.
It’s common knowledge that the misuse of antibiotics has exacerbated the problem of antimicrobial resistance (AMR). A failure to accurately diagnose many conditions has led to drugs being used in far greater quantities than necessary.
“There has been a lot of emphasis on the push for ‘cheap diagnostics’ in recent years, which has completely reduced the value that diagnostics have to play in solving the problem,” explains Barbara Fallowfield, Managing Director of the British In Vitro Diagnostics Association (BIVDA). “What’s equally concerning is that we have a tendency to focus on developing new diagnostics and ignore some of the tools already available.”
The C-reactive protein test (CRP)
One of the tools already in use is the C-reactive protein test (CRP), which can be used at the point of care to detect if a patient has a viral or bacterial infection and therefore if antibiotics should be prescribed. The test is already used in many European countries, including the Netherlands, Sweden and Germany, where fewer antibiotics have been prescribed as a direct result.
Despite the fact that the CRP has been around for more than a decade and more than 19 pilot studies carried out, it’s still not widely used in the UK, something Fallowfield feels needs to be addressed.
“It all comes down to changing behaviour,” she explains. “There are questions about who will pay for it and who will conduct the tests. Rather than being seen as an expense, diagnostics need to be seen as part of the solution with a greater willingness to adopt the test and implement it effectively.”
One of the recommendations made by Jim O’Neill in the much anticipated Review on AMR, published in May this year, was that by 2020 mandatory testing should take place in all high-income countries before antibiotics are prescribed. In order to achieve this, more funding is needed and authorities need to do more to incentivise the use of rapid point-of-care diagnostics.
Encouraging research
The report also calls for a more multinational approach to innovation in diagnostics. One initiative aimed at kick-starting research is the Longitude Prize, which will award £10million to a project that provides a cost-effective and easy-to-use test for bacterial infections that will allow health professionals worldwide to administer the right antibiotics at the right time.
“It’s really exciting to see such investment in research and development in this area,” says Fallowfield. “But it needs to go hand-in-hand with greater use of the tools we currently have, innovation of existing resources and better surveillance so we have a global picture and can target support appropriately.” When taking on the ‘biggest global health threat,’ there is no easy solution, which is why investment in all aspects of research and development, including diagnostics, is vital.
