Bacteria and fungi with the ability to withstand the drugs meant to kill them are now causing 1.2 million deaths every year, according to a global study. This represents a big jump from previous estimates of 700,000 deaths a year, and has prompted researchers to call for concentrated efforts that include infection prevention and vaccination to deal with antibiotic resistance. 

Antimicrobial resistance (AMR) has been described as the most alarming issue for human health, expected to cause up to 10 million deaths after 2050 – the same as the number of people that die from cancer every year in present times. It can affect people at any stage of life, also affecting the agriculture, veterinary and healthcare industries. It’s also a problem that will likely grow more and more as time passes.

The problem roughly goes like this: when a new antibiotic is introduced, it is generally very good at killing the pathogens it’s meant to kill. But in time, bacteria and fungi can grow more and more resistant to it, especially if people don’t take antibiotics properly. Evolutionary pressure pushes the pathogens to develop more and more resistance, until they can render the antibiotic useless. We’re already seeing this with some strains of gonorrhea, which are virtually untreatable, and several other types of bacteria. This means we constantly need a fresh supply of antibiotics to ensure we can defeat these bacteria and fungi, but developing new antibiotics is slow — slowly but surely, we’re losing the upper hand.

The World Health Organization (WHO) warned last year that none of the 43 antibiotics in development as well as the recently approved medicines are enough to take antimicrobial resistance. Of the 43 drugs in development, 26 target dangerous superbugs, but they are derivatives of existing classes of antibiotics, the WHO warned.

“AMR is a leading cause of death around the world, with the highest burdens in low-resource settings. Understanding the burden of AMR and the leading pathogen–drug combinations contributing to it is crucial to making informed and location-specific policy decisions, particularly about infection prevention,” the researchers wrote. 

The effects of superbugs

The Global Research on Antimicrobial Resistance report, published in The Lancet, is based on modelling that incorporates a wide range of data sources – including lab results, hospital records and surveillance information from pharmaceutical companies. It’s the first comprehensive assessment of the global burden of AMR, the researchers said.

The analysis covers more than 200 countries and territories. AMR was directly responsible for 1.27 million deaths, and associated with 4.95 million deaths, in 2019 – more than malaria or HIV/Aids. Hundreds of thousands of deaths happen due to common and previously treatable infections, as bacteria that cause them is now resistant to treatment.

People of all ages are affected by AMR, the researchers said, with young children being particularly at risk. One in five deaths happened in kids under five years old. AMR’s impact was described as more severe in South Asia and Sub-Saharan Africa. However, data was limited for some regions, especially for low and middle-income countries, which could alter the estimates.

Addressing the challenge of AMR will require a set of intervention strategies, the researchers said. Infection prevention and control is the most important area, including community-based programs and hospital-based infection prevention. Vaccination programs can also reduce AMR emergence, even for pathogens without vaccines. 

“Minimising the use of antibiotics when they are not necessary to improve human health—such as treating viral infections—should be prioritized,” the researchers wrote. “Maintaining investment in the development pipeline for new antibiotics—and access to second-line antibiotics in locations without widespread access—is essential.”

The study was published in The Lancet.