Antimicrobial resistance (AMR), the ability of microorganisms to evolve and render antimicrobial drugs ineffective, is sadly a crisis of our own making; a consequence of our over-reliance and misuse of these life-saving medications. 

Historically, the human race has triumphed over infectious diseases that have posed existential threats — from the Black Death of the 14th century, to the Spanish Flu that swept across the globe in 1918, to Smallpox, one of the deadliest diseases in human history. As a result, many argue we have become complacent; prescribing antibiotics indiscriminately and feeding the very mechanisms that breed resistance.

Today, the rise of AMR is one of the top global public health and development threats, jeopardising the effective prevention and treatment of an ever-increasing range of infections caused by bacteria, parasites, viruses and fungi.  

The emergence and spread of drug-resistant pathogens threatens our ability to treat common infections, but also to perform life-saving procedures such as cancer chemotherapy, caesarean section, hip replacements, organ transplantation and other major surgeries.

It’s already a leading cause of death around the world, with the highest burdens in low and middle income countries, nations with high antibiotic consumption, and regions with high rates of specific infections, like multidrug-resistant tuberculosis (MDR-TB), which is a major issue in parts of Europe, Africa and Asia.

In countries that lack access to clean water and sanitation, water is a primary vector in the spread of AMR diseases. In general, water access and pollution control has a major effect on AMR development and outcomes.

The Review on Antimicrobial Resistance, commissioned by the UK Government and published in 2016, argued that AMR could kill 10 million people per year by 2050. The review also underscored the significant economic impact of AMR, including increased healthcare costs, lost productivity, and reduced agricultural output. The projected economic burden of AMR could reach trillions of dollars by 2050, posing a substantial threat to global prosperity and development.

The global impacts of AMR

In 2019, AMR directly caused 1.27 million deaths worldwide and contributed to 4.95 million deaths, according to a study published in The Lancet. What’s more, drug-resistant infections impact the health of animals and plants, reduce productivity in farms, and threaten food security.

Misuse and overuse of antimicrobials in humans, animals, and plants are the primary drivers of drug-resistant pathogens. In agriculture, antimicrobials are frequently administered to livestock and crops as growth promoters or for disease prevention, contributing to the spread of resistance in the environment.

The economic costs

The cost of AMR is staggering for both health systems and national economies, with estimates suggesting up to US$1 trillion in additional healthcare expenses by 2050 and annual GDP losses of US$1-3.4 trillion by 2030.

If left unchecked, it’s estimated that antimicrobial resistance will push 24 million people into extreme poverty by 2030, and result in a loss of $13 billion in livestock value per year. 

Challenges and solutions

According to the World Health Organisation (WHO), the world faces an antibiotics pipeline and access crisis, with inadequate research and development in the realm of AMR, and an urgent need for additional measures to ensure access to new vaccines, diagnostics and medicines.

It’s clear that addressing the challenge of AMR requires a multifaceted and coordinated approach, at national, regional, and global levels, and that efforts need to focus on promoting responsible antimicrobial use in healthcare, agriculture, and the environment — as well as strengthening surveillance systems to monitor the emergence and spread of resistant pathogens. 

What is the UK doing?

Professor Dame Sally Davies, the UK Special Envoy on AMR, works closely with the UK government and foreign governments, international organisations and multilateral groups and sectors to advocate on AMR, maintain global momentum, and drive action to tackle the crisis.

Professor Dame Sally Davies, UK Special Envoy on AMR

Since 2020, Dame Sally has been a member of the UN Global Leaders Group on Antimicrobial Resistance, co-chaired by Prime Minister Mia Mottley of Barbados and Sheikh Hasina Wazed, Prime Minister of Bangladesh. 

With the support of the Global Leaders Group, a high-level meeting on AMR is due to be held in New York this September during the UN General Assembly for 2024. The meeting will provide an important opportunity for countries to make ambitious commitments and agree targets, and ensure optimal participation and inputs from the human, animal, agri-food and environment sectors.

Leading charities tackling the AMR crisis

A number of organisations in the UK are striving to tackle this major global health threat, including Antibiotic Research UK, a charity dedicated to fighting antibiotic resistance.  Founded in 2014, the charity was set up as a virtual charity, enabling more donations to be spent on research into new antibiotics, and allowing world-class experts to be an integral part of their work, wherever they are in the world.  

Their key mission is to tackle the global threat of drug-resistant infections by driving and enabling innovative and collaborative research, supporting patients and families that are affected by drug-resistant infections, and by working in partnership with key stakeholders to raise awareness and reduce the spread of drug-resistant infections.

The British Society for Antimicrobial Chemotherapy (BSAC) is another charity at the forefront of the fight against antimicrobial resistance, working as a global educator, linking up scientific researchers, medical communities and the wider public in efforts to stop the growing threat of drug-resistant infections. 

Through its Global Antimicrobial Stewardship Partnership Hub (GASPH), it brings people and industry together to improve education and training across the global infection healthcare community, while its Global Antimicrobial Stewardship Accreditation Scheme helps healthcare facilities measure and enhance antimicrobial stewardship and data collection.

Raising awareness and understanding of antimicrobial resistance

Defending Our Health: Unravelling Antimicrobial Resistance is an ITN Business news-style programme launching in September 2024, and presented by journalist and broadcaster, Sharon Thomas. The programme will explore a range of themes, including the overuse and misuse of antibiotics, the impact on Sustainable Development Goals, the One Health approach, the development of new antibiotics, infection prevention and control. It will also feature an exclusive interview with Professor Dame Sally Davies.

Several recently published books are helping to shed light on the complex and urgent issue of antimicrobial resistance (AMR), offering insights into its origins, impact, and potential solutions. Here are a few of the most noteworthy reads:

1. The Pandemic Century: One Hundred Years of Panic, Hysteria, and Hubris by Mark Honigsbaum (2020)

Honigsbaum traces the history of pandemics over the past century, exploring the societal responses to outbreaks of infectious diseases and the lessons learned from each crisis. In the context of AMR, he examines how past pandemics have shaped our understanding of microbial threats and influenced efforts to combat antibiotic resistance.

2. Superbugs: The Race to Stop an Epidemic by Matt McCarthy (2019)

McCarthy, an infectious disease specialist, provides a gripping account of the rise of antibiotic-resistant bacteria and the challenges faced by healthcare professionals in combating them. Through vivid storytelling and real-life experiences, he explores the human cost of AMR and calls for urgent action to address this global threat.

3. Big Chicken: The Incredible Story of How Antibiotics Created Modern Agriculture and Changed the Way the World Eats by Maryn McKenna (2017)

McKenna delves into the link between the use of antibiotics in agriculture and the emergence of antibiotic-resistant bacteria. Drawing on extensive research and interviews, she reveals how the widespread use of antibiotics in food production has contributed to the proliferation of resistant strains, posing risks to both human health and the environment.

Prefer a podcast? Some essential listening:

1. BBC Discovery: ‘The Evidence: Drug-resistant superbugs’

2. Superbugs Unplugged series

3. Let’s Talk Cancer: ‘Superbugs and drug resistance: A threat to humanity’

 

Learn more about ITN Business’ Defending our Health: Unravelling Antimicrobial Resistance programme coming this September.