The IOI is dedicated to delivering the research, providing the education, and fostering the global collaboration required to address the growing public health threat of antimicrobial resistance.
What is AMR?
The living organisms (such as bacteria, viruses, fungi) which cause infections are constantly evolving to fight against our protective drugs- we are losing the arms race. This is a natural process, but sped up by the global mismanagement of drugs- especially antibiotics- which aids development of antimicrobial resistance (AMR). We urgently need to scale up our fight, to mitigate the damage.
Drug-resistant infections already contribute to at least 700,000 deaths a year. Given the current trajectory, drug resistance could lead to 10 million deaths annually by 2050.
Bacterial infections, commonly treated with antibiotics make up a large part of these. Antibiotics are a cornerstone of modern medicine. They allow us to fight numerous deadly infections and safely conduct surgery, chemotherapy and other essential treatments.
AMR will threaten public health significantly as routine interventions, such as chemotherapy, organ transplants and other major surgeries worldwide become too risky to undertake. It is expected that AMR will cause a global economic cost of estimated $100tn by 2050 (disproportionately affecting low income countries). This could plunge 24 million people into extreme poverty.
AMR is one of the most complex and multifaceted health challenges facing the global community today, and the next few years will define the trajectory of the long-term global AMR response and how successful it can be. The time to act- to prevent the unthinkable from becoming the inevitable- is now.
A history of antibiotic discovery at Oxford
The history of antibiotic development is inextricably tied to Oxford University, and the culture of British innovation within its faculties- which includes the most recent and well-known development of an effective Covid-19 vaccine, and promising progress on tackling malaria.
Antibiotics were only invented and scaled up to become viable drugs in the 1940s, but now underpin all modern medicine. Oxford University played a lead role in the development of Penicillin, the first antibiotic- and remains a leader in the field.
The story of antibiotics began when Alexander Fleming discovered the mould Penicillium notatum at St Mary’s Hospital, London in 1928. It was the Oxford scientist, Norman Heatley who first discovered how to synthesise the drug to make it scalable. Oxford Nobel Prize winner Dorothy Hodgkin assisted its manufacture by mapping its chemical structure.
From 1938 the Penicillin drug was developed and synthesised by 2 scientists at the Dunn School of Pathology, Oxford University- Howard Florey and Ernest Chain. Together they won the Nobel Prize with Fleming in 1944. In the UK by the end of 1945, 8 British companies were producing penicillin in 12 different factories- including the chemical producer ICI, pharmacist Boots, and the Royal Navy. In the US, Pfizer quickly became the world’s largest producer of penicillin.
Enormous WW2 military demand for penicillin was a key reason for the rapid increase in global production. Usually competitive corporate executives freely exchanged information about the market and the production technologies used, with huge positive impact.
In the second half of the 1940s, the use of penicillin surged across Europe. Post-war the newly founded World Health Organization built its own penicillin factories to make the drug globally available. However by 1946, the age of commercial openness about penicillin production was over.
Antibiotic discovery drives through the 1940s and 1950s yielded great success, and Penicillin was quickly succeeded by several other classes of effective antibiotics - including Streptomycin and Cephalosporin. In his 1945 Nobel Prize lecture, however, Alexander Fleming spoke of the dangers of antibiotic ‘underdosage’ and warned that common bacteria could evolve to become resistant to the new wonder drugs- a phenomenon which did very quickly develop. Within a decade a number of newly antibiotic-resistant bacteria strains spread among humans and animal populations around the globe and caused major epidemics- a process which is still ongoing.
Since the 1980s pharmaceutical business models have shifted to longer term use drugs, and no novel antibiotics have emerged to tackle the increasingly resistant strains of bacteria growing constantly.
We intend to put Oxford back at the forefront of the antibacterial fight, investing in the core science underpinning drug discovery to enable the next breakthroughs. The IOI will bring together some of the brightest minds across several scientific specialisms, and make optimal use of major infrastructure investments at the University to spearhead novel research into the scale and solutions for our global AMR challenges. It intends to work collaboratively with other leading AMR teams to share research and expedite its findings.