LONDON - Health leaders have warned of the serious threat posed by antimicrobial resistance after a study found it has become a leading cause of death worldwide, killing about 3,500 people every day.
More than 1.2 million people – and potentially millions more – died in 2019 as a direct result of antibiotic-resistant bacterial infections, more than from HIV/Aids or malaria.
One in five deaths attributable to AMR have occurred in children under the age of five.
Deaths caused directly by AMR were estimated to be highest in sub-Saharan Africa and south Asia.
Why antibiotic resistance is a ‘slow-moving pandemic’
The emergence of germs that are resistant to most drugs is one of the biggest public health challenges of our time.
More than 700,000 people die every year because they are infected with microbes – bacteria, viruses, fungi or parasites – that have become resistant to most known drugs.
Antimicrobial resistance (AMR) is already a major public health problem around the world, though its effects are felt unequally: while an estimated 17% of infections in OECD countries are caused by drug-resistant microbes, 40%-60% of infections in Brazil, Indonesia and Russia are caused by such microbes.
Left unchecked, AMR threatens to become one of the world’s biggest health problems, surpassing diabetes and cancer. If more bugs become drug resistant, common infections could become untreatable, and routine treatments – chemotherapy, caesareans, hip replacements – too risky to carry out.
In 2019, a UN report estimated that drug-resistant microbes could lead to ten million deaths per year, and cost the world $100trn, by 2050. The Wellcome Trust has called AMR a “slow-moving pandemic”.
How do microbes become resistant?
Because of evolution by natural selection. Each time living things reproduce, their genetic code mutates. Often those mutations have little impact on the next generation. But sometimes they confer a survival advantage – perhaps the new generation of microbes need less food or water to survive, or maybe they are unaffected by the drugs that used to kill their ancestors.
Anti-microbial drugs increase the selection pressure: newer, resistant bugs survive and reproduce further. Over time, the only microbes that are left are the ones resistant to common drugs.
The most infamous examples of so-called “superbugs” are methicillin-resistant Staphylococcus aureus (MRSA) and drug-resistant tuberculosis – both caused by bacteria that are very difficult to treat with existing medicines. Drug resistance is nothing new, but the rate at which resistant bugs are appearing is growing fast and, worryingly, the supply of new drugs with which to treat them is drying up.
