Without major changes, antimicrobial resistance could kill more than 39 million people by 2050

Remember what happened the last time political leaders ignored scientists’ warnings about the threat of an infectious disease? Well, over the past two decades, scientists have been pushing for more urgent action against antimicrobial resistance, or AMR. Otherwise, more than 39 million deaths from AMR could occur over the next 25 years, from 2025 to 2050. according to a new study just published in The Lancet. That would mean a lot of deaths, many of which could still be prevented if things change. Will this be the number that ultimately prompts much more urgent action from political and business leaders around the world? Or will it be yet another ominous statistic about AMR that will be ignored until we reach the holy-cow-how-did-we-here stage?

To arrive at this 39 million figure, a large team of researchers collected and used a range of different data from hospitals, insurance claims, surveys, drug sales and other sources to calculate the number of deaths and levels of disability that result were of a range of different antibiotic resistance bacteria in 204 countries and territories from 1990 to 2021. They then used statistical methods to extrapolate what would happen if the same trends continued, versus situations where the quality of healthcare and access to appropriate antimicrobials in improved over the next quarter century. The researchers found that deaths from AMR among people aged 70 and over increased by more than 80% between 1990 and 2021. They predict that by 2050 there will be approximately 1.91 million deaths directly attributable to AMR, and approximately 8.22 million deaths associated with AMR. world.

This certainly wasn’t the first study to show how bad AMR (or AR if you don’t want to say ‘M’) has become and how much worse it could get. In June, The Lancet published a very special issue who has tried to get to the heart of this problem. The World Health Organization (WHO) has included AMR among the top 10 threats to global health. And “CDC is continuously working to increase education and awareness about the threat of AR across all sectors and audiences, including the public, healthcare providers, policymakers and global partners,” said Michael Craig, MPP, director of Antimicrobial Resistance Coordination and Strategy Unit at the Centers for Disease Control and Prevention. “CDCs Be aware of antibiotics And Get ahead of sepsis are two examples of educational efforts.” He added: “The interactive AR investment card makes information about CDC’s investments in the AR fight publicly available online.”

Many other studies, symposia and advisory bodies have sounded the alarm. For example, in September 2023, I moderated a panel at the World Anti-Mopathic Resistance Congress and Disease Prevention and Control Summit in Philadelphia, Pennsylvania, entitled “How Can We Bring AMR to the Front of Preparedness,” which asked exactly that question: as covered by Caitlyn Stulpin for Healio. But where is the sense of urgency among political leaders? Why hasn’t AMR been part of the political discourse ahead of the US November elections?

This may sound like déjà vu all over again when many political leaders failed to listen to scientists warning of the possibility of another pandemic years before Covid-19 struck in 2020. But unlike Covid-19, the current AMR situation does not involve just one pathogen and will not improve with a vaccine and more exposure to the pathogen. AMR occurs when a microorganism such as bacteria, viruses, fungi or parasites is no longer susceptible to currently available antimicrobial treatments. AMR has become more of a slow-motion catastrophe as more and more antibiotic-resistant pathogens have emerged over the years. There is an alphabet soup of different microorganisms that have developed AMR, such as MRSA, VRE, CRE and ESBLs. In fact, the situation has become so bad that researchers have had to come up with new abbreviations such as MDROs (multi-drug resistant organisms) and XDROs (extensively drug resistant organisms) to describe the increasing level of resistance that has emerged in various microorganisms. .

The danger is that our society could return to the infection Dark Ages, where even simple infections could quickly become death sentences because people lacked effective treatments. It’s easy to forget the years before 1928, when an accidental discovery by Alexander Fleming, MBBS, led to the development of the world’s first true antibiotic: penicillin. Before antibiotics were easily available, even small cuts could shorten a person’s life.

Although penicillin was a game-changer, microorganisms were able to quickly adapt to evolving mutations to neutralize the effects of this antibiotic, kind of like those robot guards in the movie. X-Men: Days of Future Past. When this happened, people responded with a new and improved antibiotic. But then the bacteria basically came back with, “I see your new antibiotic and I’m putting in this new mutation for you to counteract that antibiotic.” Of course, bacteria don’t really talk in human language. But that’s essentially what bacteria and other microorganisms have done repeatedly since then. Over the next half century, humans managed to stay one step ahead of microorganisms and their mutating ways in this arms race.

But by the time the 2000s rolled around, two things had been going on for a while. One is that people overused antibiotics for things like sore throats and various medical and dental procedures, even when bacteria weren’t actually the problem. Such overuse has further accelerated the development of antimicrobial resistance. The second problem is that innovation in antibiotics has slowed to a snail’s pace. “Major pharmaceutical companies have exited the anti-infectious R&D space over the past fifteen years, driving pharmaceutical investment and technical knowledge into other areas,” explains Mark Albrecht, PhD, head of the Antibacterials Branch of the Biomedical Advanced Research and Development Authority out. BARDA), part of the U.S. Department of Health and Human Services. As a result, very few new antibiotics have come onto the market over the past twenty years. Both trends have allowed pathogens to win the arms race. The concern is that we may be reaching a point of no return.

Both Craig and Albecht mentioned how the complexity of AMR and dealing with it can complicate reporting on the issue. Albrecht lamented: “After decades of access to effective antimicrobials, we have taken their life-saving potential for granted and underestimated how difficult it can be to treat infections that are resistant to existing treatment options.” And Craig emphasized: “Fighting AR requires a global approach One health approach, where we work at local, regional, national and global levels to achieve optimal health outcomes for people, animals, plants and our shared environment.”

Both pointed out the need for more attention, investment and innovation in tackling AMR. Craig warned, “Without sustained funding, CDC will not be able to maintain current levels of effort or expand domestic and global AR programs.” And Albrecht insisted: “We need innovation not only in development, but also in push and pull incentives that result in greater commercial sustainability for new antimicrobials. Antimicrobials need better financial and reimbursement models to provide a return on investment that balances with stewardship.”

At some point, this resistance to investing much more in developing more antibiotics and combating AMR must be overcome. Otherwise, our society will no longer be able to withstand the slow-motion catastrophe that AMR has become.