Reducing action on antimicrobial resistance is doable and affordable
Global Action to Combat Antimicrobial Resistance at the UN High-Energy Meeting on the Emerging Challenges of Low-Segregation Countries
Malaria and most bacterial infections do not last as long as do tuberculosis or AIDS, from which people tend to die months or years after infection. A child with an infection who develops a fever in the morning can be dead the next day if they don’t receive the right antibiotics. In low- and middle-income countries those are not available in public-sector clinics. Parents and other caregivers often turn to their local pharmacy for help. The pharmacy industry is more difficult than public-sector ones to set up systems that limit the entry of inappropriate, poor- quality or fake drugs.
It is estimated in the report that 1.91 million deaths each year could be caused by antimicrobial resistance, while another 8.22 million people will die from illnesses associated with resistance. People over 70 will be most at risk of death in the year 2050.
This is the second time that the company has been in the spotlight at the UN. The problem has been highlighted in the first one as it is associated with five million deaths a year. Although there has been some progress in the past eight years, such as the development of national action plans by many countries, the pace of change has been slow. I am presenting at the upcoming meeting, and I hope to convince attendees that the next eight years could look very different.
International funders, such as the Global Fund, must step up. People with HIV have a high risk of developing bacterial, viral, fungal and protozoal infections. The Global Fund has an existing mandate to give people access to effective diagnostics and antibiotics, which would make this an extension of that mandate.
Furthermore, prevention strategies — especially the provision of vaccines, safe water and good sanitation — need to be supported by organizations such as Gavi, the Vaccine Alliance, as well as through bilateral donors, including the United States Agency for International Development in Washington DC. They also need to be prioritized in national budgets in low- and middle-income countries.
With investment from global funders, specific targets and accountability through an independent panel, there is a much higher chance of this year’s discussions at the General Assembly translating into global action to tackle AMR.
The authors hope the report will “guide information on how to develop new drugs, which new drugs to focus on, what new vaccines to focus on”, says co-author Eve Wool, a research manager at the Institute for Health Metrics and Evaluation in Seattle, Washington.
Policymakers should also address the overuse of antibiotics in farming, which speeds up bacterial resistance, and invest in research for innovative antibiotic drugs, Walsh says.
South Asia, Latin America and the Caribbean are Regions with the highest predicted mortality rates.
“This study shows we have a problem in health-system quality and prevention of infections,” says co-author Mohsen Naghavi, a physician and epidemiologist at the University of Washington in Seattle.
Many of the deadliest infections between 1990 and 2021 were caused by a group of bacteria with particularly strong drug resistance, called gram-negative bacteria. This category includes Escherichia coli and Acinetobacter baumannii — a pathogen associated with hospital-acquired infections.
The researchers looked at mortality information and hospital records from 204 countries from 1990 to 2021, focusing on 22 pathogens, 84 combinations ofbacteria and drugs resistant to and 11 diseases.
“This is an important contribution for understanding how we’ve gotten where we are, and for giving a rational expectation of the future burden of [resistance] in order to inform next steps that can be undertaken,” says Joseph Lewnard, an epidemiologist at the University of California, Berkeley.
A WHO report has claimed that nearly 5 crore deaths a year could be caused by antimicrobial resistance, which can be caused by various bacteria, viruses and parasites. The problem is associated with five million deaths a year. People over 70 will be most at risk of death in the year 2050, the report added.