There are multiple areas where the United Kingdom’s departure from the European Union may affect how antimicrobial resistance (AMR) is addressed. AMR is a global health issue, with strategic coordination occurring at several levels to address the issue—from the World Health Organisation, to the EU, and in the UK’s national health strategy. The World Bank has predicted that, globally, AMR will lead to increases in morbidity and mortality, increase the burden on healthcare systems, increase extreme poverty, and that it could inflict heavy losses on the global economy.
Access to the latest effective antibiotics is important for the treatment of patients and the mitigation of resistance development, and may be affected by changes in the development and regulation of new medicines—both of which pose particular challenges with regards to antimicrobials, and especially antibiotics. The UK has been heavily involved in medicine development and regulation in the EU, and the European Medicines Agency is currently based in London (though it will relocate to Amsterdam following the UK’s departure from the EU). The UK Government has stated that it wishes to continue to participate in the European Medicines Agency under new arrangements that recognise the UK will not be a member state.
Trade agreements regarding food and agriculture have been highlighted by commentators as presenting both risk and opportunity in the context of AMR. Responsible antimicrobial use on farms is a key issue for AMR, and whether the UK maintains or reduces regulation in this area may be dependent on future trading arrangements. Michael Gove, Secretary of State for Environment, Food, and Rural Affairs, has stated there should be no compromise on animal welfare and environmental standards, and that the high levels of antibiotic use in agriculture in the United States are a concern. The UK Government has argued that being outside the EU Common Agricultural Policy would provide the freedom to apply higher animal welfare standards.
A key part of the EU’s strategy against AMR is the development of epidemiological surveillance infrastructure across the member states. The UK Government has proposed continued close collaboration with the European Centre for Disease Prevention and Control including access to alert systems, databases, and networks.
