Source · Select Committees · Public Accounts Committee
Recommendation 12
12
Acknowledged
Most domestic targets in 2019-24 AMR National Action Plan remained unachieved
Conclusion
As part of its 2019–24 National Action Plan for AMR, the third UK plan of its kind, the government set five domestic targets. These related to levels of drug-resistant and Gram-negative bloodstream infections (named after a bacteria-testing method and are more likely to be resistant to antimicrobials), use of antimicrobials in humans and animals, and use of diagnostic tests.29 However, only one of these five targets, relating to use of antimicrobials in animals, was achieved. NHS England told us that the 22 Qq 56–62 23 Q 62 24 Qq 60, 61 25 Q 16; C&AG’s Report, paras 2.7, 3.20 26 Q 43 27 House of Commons Library, US aid, the UK, and funding for multilateral aid bodies in 2025, 18 March 2025 28 AR0007, AR0009, AR0015, AR0021, AR0025 29 C&AG’s Report, paras 8, 2.11 and 2.14 11 targets were not achieved as they were overambitious, and the targets had been based on previous success with other targeted infections such as MRSA, which involve a different mode of transmission, as well as the impact of the pandemic such as a post-pandemic resurgence of infections. NHS England believes that progress was still made even though the targets were not hit.30
Government Response Summary
The government agrees with the observation and details its processes for closely monitoring and annually reviewing NAP human health targets, using data and expert advice to guide future action and potential revisions.
Government Response
Acknowledged
HM Government
Acknowledged
2.1 The government agrees with the Committee’s recommendation. Target implementation date: Winter 2025 2.2 Progress against NAP human health targets is closely monitored, using data to assess effectiveness, guide future action, and ensure alignment with broader public health objectives. The government conducts formal reporting on these targets biannually. Additionally, targets are subject to annual review over the summer, with the potential to revise, if deemed appropriate and agreed by the UK AMR Strategy Board. 2.3 Analysis of surveillance trends will inform recommendations on the range and ambition of targets. UKHSA will also model trends in specific drug-resistant infections, accounting for population changes, to project counterfactual trends. Expert advice on target revisions will be sought from the Advisory Committee on Antimicrobial Prescribing, Resistance and Healthcare Associated Infection. 2.4 The government supports achievable targets being set, to help secure support from the healthcare system and contribute to long-term change. UKHSA predicts the incidence of drug-resistant and gram-negative blood stream infections will continue to rise due to 20 increasing age, medical comorbidities, and population demographic changes. Therefore, preventing an increase in these infections from the 2019 baseline is currently ambitious. 2.5 The government has previously supported targets developed by the livestock sectors through the Responsible Use of Medicines in Agriculture Alliance (RUMA) Targets Task Force on AMR, which have resulted in a 59% reduction in antibiotic use in livestock since 2014. The livestock sectors, coordinated by RUMA, are developing a new set of sector-specific targets, which are due to be published in late 2025. If sufficiently ambitious, the Vetinary Medicines Directorate (VMD) will incorporate them into the NAP delivery programme.