What is antimicrobial resistance?

A nurse prepares to administer a malaria vaccine to an infant at the health center in Datcheka, Cameroon January 22, 2024. REUTERS/Desire Danga Essigue
explainer

A nurse prepares to administer a malaria vaccine to an infant at the health center in Datcheka, Cameroon January 22, 2024. REUTERS/Desire Danga Essigue

What’s the context?

Drug-resistant diseases are on the rise; experts say urgent change is needed to save millions of lives

  • Drug-resistant diseases may kill 39 million by 2050
  • Human activity has rapidly accelerated spread of AMR
  • Global South countries forecast to suffer most deaths

LONDON - Antimicrobial resistance (AMR), when harmful micro-organisms become resistant to medicines, could become the next potential global health crisis, with experts predicting it could lead to 39 million deaths between 2025 and 2050.

Here is what you need to know.

What is antimicrobial resistance?

AMR is when harmful micro-organisms develop a resistance to drugs or medicines designed to treat an infection, virus or illness and the treatment no longer works.

Microbials are tiny organisms found in all living things. While not all bad, harmful types include bacteria, viruses, fungi and parasites. Antimicrobials can kill or inhibit the growth of these organisms.

For more than a century manufactured antimicrobials, like antibiotics, have been used to help the body fight illness.

Diseases like typhoid, cholera, meningitis, chlamydia and other sexually transmitted diseases, as well as tuberculosis and HIV/AIDS are all caused by harmful microbes. AMR could render existing treatments useless or less effective.

The World Health Organization says nearly 5 million deaths are associated with AMR globally every year and in 2021 AMR was solely responsible for more than 1 million deaths.  

Children are most at risk. In 2019, one-in-five AMR deaths was in the under fives.

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What causes antimicrobial resistance?

AMR does occur naturally via genetic mutations, but experts say human activity has rapidly accelerated the frequency of those changes.  

More people than ever are using antimicrobials, such as antibiotics. The drugs kill most harmful microbes, but some are able to survive and over time these become more numerous.

AMR also increases when drugs are taken for infections and viruses they cannot treat.

For example, antibiotics only work against infections caused by bacteria and not against viruses that cause colds, flu or COVID-19. During the pandemic, the WHO found that "extensive overuse of antibiotics" may have spread the growth of AMR.

While only 8% of COVID hospitalisations involved bacterial co-infections requiring antibiotics, 75% of patients were found to have been given antibiotics.

Globally, the European Commission estimates that just half of antibiotics are used correctly.

Poor hand hygiene and infection control has also been linked to the spread of drug-resistant microbes.

What is the economic cost of antimicrobial resistance?

Alongside its fatal consequences, there is an economic cost.

According to the European Commission, drug-resistant bacteria in the EU could cost 1.5 billion euros ($1.65 billion) each year in healthcare costs and productivity losses.

By 2050, expected cumulative losses in OECD countries could reach up to $2.9 trillion.

WHO data says that by 2030, AMR could push more than 24 million people into extreme poverty and lead to economic damages similar to the 2008-2009 financial crash.

AMR also increases the risk of 'superbugs' - microbes resistant to multiple forms of treatment.

Bottles containing malaria vaccine stand on the table at the health center in Datcheka, Cameroon January 22, 2024. REUTERS/Desire Danga Essigue

Bottles containing malaria vaccine stand on the table at the health center in Datcheka, Cameroon January 22, 2024. REUTERS/Desire Danga Essigue

Bottles containing malaria vaccine stand on the table at the health center in Datcheka, Cameroon January 22, 2024. REUTERS/Desire Danga Essigue

Where are the AMR hotspots?

AMR is found all over the world, but affects low and middle-income countries the most.

Africa faces the highest AMR mortality rate - more than the combined toll from HIV-AIDS, tuberculosis and malaria, the Africa Centres for Disease Control and Prevention says.

The WHO estimates that unless action is taken, AMR could kill more than 4 million people across the continent. 

Latin America and southern Asia are also expected to see a rise in AMR-related deaths, with the latter forecast to see more than 11 million deaths between 2025 and 2050.

What is being done to tackle AMR? 

Creating antibiotics immune to AMR is extremely costly and not currently possible given the fast rate at which AMR is spreading. Research has focused on finding a way to extend the lifespan of existing antimicrobials.

In 2022, scientists where able to isolate and inhibit a bacterial protein known as DsbA, disrupting the creation of drug-resistant bacteria. However, they used a chemical that cannot be used in humans.

Attention has now focused on developing a way to use inhibitors that can be used in humans and achieve the same effect.

In 2015, the WHO established the 'Global Antimicrobial Resistance Action Plan', which aims to reduce the spread of AMR by strengthening "effective sanitation, hygiene and infection prevention measures," finding new medicines and other measures.

A political declaration approved at the United Nations in September set a target of a 10% reduction in the nearly 5 million annual deaths associated with AMR by 2030.

The declaration also called for more sustainable financing and $100 million in 'catalytic' funding to help at least 60% of countries develop an AMR action plan by 2030.

($1 = 0.9065 euros)

(Reporting by Noah Anthony Enahoro; Editing by Jon Hemming.)


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