Marking World Antimicrobial Awareness Week (taking place November 18 to 24), the Union for International Cancer Control (UICC) emphasized the danger that drug resistance poses to individuals who are particularly vulnerable to infection, such as people living with cancer.
There has been substantial progress in cancer care over the past few decades, with key advances in surgery, radiotherapy, and medicine, 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 disease 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 one in five patients with cancer undergoing treatment are hospitalized due to infection or infectious disease such as pneumonia. Additionally, 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 overprescription 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,” commented Jeff Dunn, AO, President of UICC.
Starting in 2019, UICC set up a task force that combined experts from the oncology and infectious diseases communities. The task force selected three areas in which to focus their efforts and make policy asks to address antimicrobial resistance:
- Collect reliable data on the impact of resistant infections on patients with cancer
- Ensure availability, affordability, and sustained access to quality assured antimicrobial medicines and improve diagnostics capability
- Integrate antimicrobial resistance control into national cancer control plans with adequate funding.
At the World Cancer Congress, the UICC presented a wide-ranging report on the impact of antimicrobial resistance on cancer care outcomes. Produced by the antimicrobial resistance task force and written by over 50 experts committed to researching the scale of antimicrobial resistance and finding workable solutions, the report issues a series of recommendations, including:
- Improving public awareness: The message that antimicrobial resistance concerns everyone must be conveyed widely to limit the misuse of certain drugs.
- Creating visibility. As the COVID-19 pandemic illustrated perfectly, when numbers are reported daily, and everybody acknowledges the threat, powerful action follows.
- Engaging the health-care workforce. Health-care personnel have an active role to play in drawing attention to antimicrobial resistance, ensuring the appropriate use of medicines, and strong infection control practice in medical settings, as well as providing key input to national policy on antimicrobial resistance.
- Addressing overprescription. There need 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 health-care community to ensure appropriate and prudent use of these medicines.
- Ensuring access to diagnostics and treatment
- Encouraging the development of new medicines. As successful antimicrobials are destined to be replaced and to be successful, they must be used sparingly, and innovative funding initiatives and reimbursement models for new medicines are needed—for example, d-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.
- Designing a centralized and specialized surveillance system for people with cancer. This system will ideally be used 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.
- Strengthening infection prevention and control.
