We cannot hope to address antibiotic resistance in developing countries in the same way that we approach this global health crisis in the developed world. Strict policy interventions to reduce use of antibiotics, as employed in the UK, cannot be upheld to the same extent in countries where the burden of disease is much higher, antibiotics are accessible without prescription, and access to healthcare is much reduced.

Calls to rein in antibiotic use after study shows 65% increase worldwide Read more

A new report highlights the increase in both the use of antibiotics and access to them, particularly in developing countries. The impact on antibiotic resistance cannot be underestimated. As economies in lower- and middle-income countries grow, so does access to medicine and use of antibiotics, as the study – from the Proceedings of the National Academy of Sciences of the US – shows. A 65% rise in antibiotic use demonstrates a worrying upward trend, and the authors highlight that without significant changes antibiotic use in 2030 could be up to 200% higher than when first estimated three years ago. The need for urgent action has never been more clear.

Antibiotic resistance is not confined by borders, therefore those combating it need to have a strong interest in collaborating and supporting efforts in other countries. No one solution can address this problem; a multifaceted response is required. We must improve public education, particularly in regions where antibiotics do not require a prescription. Infection prevention and control, often seen as beyond the issue of antibiotic resistance, should be prioritised, and a significant increase in the tracking of infection and resistance rates will be needed globally.

Crucially, we must help to alter healthcare providers’ reliance on prescribing by symptoms alone, by providing them with rapid point-of-care diagnostic tests. Imagine a test that could tell a prescriber in a matter of minutes if a patient’s sore throat was caused by a virus or a bacterial infection; or one that could rapidly determine the best course of antibiotics for an antibiotic-resistant bacterial infection. If the right tests are available, clinicians will no longer need to rely on symptoms alone to make a diagnosis, or on central laboratory facilities if a test can be done in minutes at the patient’s bedside.

At the Longitude prize we have established a £10m fund to seek solutions for antibiotic resistance

At the Longitude prize we have established a £10m fund to seek solutions for antibiotic resistance, and reduce inappropriate prescriptions by incentivising the development of a rapid, point-of-care diagnostic test. This would allow clinicians to prescribe antibiotics only when needed, and ensure patients with viral infections were not given antibiotics.

Access to such innovative tests must not be limited to high-GDP countries; as we have seen from this new report, antibiotic use is particularly on the increase in developing countries and resource-poor settings, where humidity, access to power and refrigeration all need to be considered for any new diagnostic methods.

Cost is an important driver: how can we ensure diagnostics are used when antibiotics can often be bought without prescription, and for significantly less than the price of running a test? Governments and health institutions must invest in supporting their prescribers with the tools to aid accurate diagnosis of bacterial infections. The cost of antibiotic resistance is often underestimated – for example, the duration of hospital stays increases with resistant infections, which is expensive for the health system or insurer. Further cost-effectiveness studies would do much to aid the uptake of new diagnostics.

The tide of antibiotic resistance continues to rise, and the global healthcare community must work together to ensure that all countries, no matter their GDP, have access to the education and tools to tackle this emerging crisis.

• Caroline Purslow is programme manager for the Longitude prize at the Challenge Prize Centre of the innovation foundation Nesta