According to a report by the UN World Health Organization (WHO), antibiotic resistance “could cause 10 million deaths each year by 2050”, complicating routine treatment for infections and minor medical procedures.
By 2030, it’s estimated that antimicrobial resistance could displace up to 24 million people, driving extreme poverty and economic distress globally. Those numbers have some in the medical community sounding the alarm, comparing the rise in antibiotic resistance to the threat of climate change.
“The world is already feeling the economic and health consequences as crucial medicines become ineffective,” the UN warned in a summary. “Without investment from countries in all income brackets, future generations will face the disastrous impacts of uncontrolled antimicrobial resistance.”
— United Nations (@UN) April 29, 2019
UN outlines recommendations to reduce reliance on antibiotics in humans, livestock
The report cites 700,000 deaths per year as a result of antibiotic resistance, with 230,000 of those deaths from multi-drug resistant tuberculosis. Increasingly, common diseases such as UTIs and STIs are becoming untreatable, with the reliability of food systems “increasingly precarious”.
“The world is already feeling the economic and health consequences as crucial medicines become ineffective. Without investment from countries in all income brackets, future generations will face the disastrous impacts of uncontrolled antimicrobial resistance.”
The report made four recommendations:
- Policy measures to “scale-up financing and capacity-building efforts”;
- Regulations that promote the “responsible and prudent use of antimicrobials by professionals in human, animal and plant health”;
- Investment in the research and development of “new technologies to combat antimicrobial resistance”;
- Decreased use of antibiotics as “critically important growth promoters in agriculture”.
This is not the first time the UN has weighed in on antibiotic resistance.
In 2017, WHO reported that antibiotic resistance was “a global crisis that we cannot ignore”, and that if ignored, “will take us back to a time when people feared common infections and risked their lives from minor surgery”.
Others in the medical community have echoed the concern, with Athena Kourtis, Associate Director for data activities at the Centers for Disease Control and Prevention (CDC), telling Axios that antibiotic resistance is “perhaps the biggest health challenge of our time”, and that “innovative approaches … are very much needed in order to successfully prevent and treat infections with antibiotic-resistant bacteria.”
Some have gone further, with the UK’s Chief Medical Officer Dame Sally Davies comparing the emergence of antibiotic resistance to climate change.
“This is happening slowly and people adjust to where we are, but this is the equivalent [danger] to extreme weather.”
The spread of Candida auris, a deadly fungal infection, embodies a public health threat: drug-resistant germs. Outbreaks are often kept secret.https://t.co/nwar8rGS9g
— NYT Science (@NYTScience) April 7, 2019
Antibiotic resistance already widespread
Due to decades of over prescription of antibiotics as well as widespread use of antimicrobials in livestock and agriculture, humans have become increasingly resistant to drugs meant to kill bacterial and fungal infections. Because of this, antibiotic resistant germs are “difficult, and sometimes impossible, to treat”, and can require lengthy hospital stays and toxic alternatives, according to the CDC.
Already, cases of difficult to treat bacterial diseases have been reported, and in some cases have involved invasive surgery to remedy the problem.
Per The New York Times, some hospitals are hesitant to discuss cases of drug-resistant disease, with the paper reporting that “the rise in resistant bugs is cloaked in widespread and chronic secrecy.”
In one case, the paper had come across a patient who was prescribed antibiotics, only to find “they didn’t work” and that multiple surgeries were required to clear the underlying infection. Further complications from antibiotics meant the patient had to have her gallbladder removed.
Already, more than two million people are infected with antibiotic-resistant bacteria in the US annually, of which more than 20,000 people die as a result. With resistance increasing, it’s been projected that by 2050, 10 million people will die from antibiotic resistance, as opposed to more than eight million projected to die of cancer.
While the over prescription of antibiotics remains a problem, so too does incidental consumption. In the US, which already treats its livestock with more antibiotics than anywhere else in the world, more than half of those that are fed to farm animals can have an impact on humans when consumed.
The world is running out of useful antibiotics because the rise of antibiotic resistance in bacteria is undermining them, and big firms are disinclined to make more. If we want new ones, we're going to have to find new ways to pay for them. https://t.co/5Qe1RsQFJj
— WIRED (@WIRED) April 25, 2019
Stronger action required on the part of regulators and medical bodies
With antibiotics becoming increasingly ineffective, businesses are now “disinclined” to manufacture them, reflecting the economic impact of antimicrobial resistance.
In addition, some professionals have warned that solutions similar to those outlined by the UN may be difficult to achieve.
Writing for The Conversation UK, Professor Andrew M Colman says that “prescribing antibiotics whenever a bacterial infection seems possible remains (a doctor’s) best strategy”, and that “special measures” will be needed to confront the problem. That includes improved regulations and access rights, further publicity of antimicrobial resistance, team-based decision-making on prescriptions and incentives reform.
“There is no point in merely appealing to doctors to change their prescribing behaviour,” wrote the Professor. “But that doesn’t mean nothing can be done about it.”