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What is AMR?

Antibiotics are a cornerstone of modern medicine. They allow us to fight numerous deadly infections and safely conduct surgery, chemotherapy and other essential treatments. Living organisms (such as bacteria, viruses, fungi) which cause infections are constantly evolving to fight against our protective drugs - presently, we are losing this arms race.

Antimicrobial Resistance (AMR) is a natural process, which has been accelerated by the global mismanagement of drugs - especially antibiotics - which aids the development of AMR. Current data suggests that drug-resistant bacterial infections cause at least 1.3M deaths a year. Given the current trajectory, AMR could lead to 10 million deaths annually by 2050.

AMR threatens public health significantly because common treatments, such as chemotherapy, organ transplants and other major surgeries can become too risky to undertake routinely. We urgently need to scale up our efforts, to manage our existing antibiotic treatments better and develop new ones.

It is expected that AMR will cause a global economic cost of an estimated $100tn by 2050 (disproportionately affecting low-income countries). This could plunge 24 million people into extreme poverty.

AMR is one of the most complex and multifaceted health challenges facing the global community today. The next few years will define the trajectory of the long-term global AMR response and how successful it can be. The time to act- to prevent the unthinkable from becoming the inevitable - is now.

Antimicrobial Resistance

Antimicrobials are substances which act against microbes (including bacteria, viruses and fungi). They are often used as medicines (antibiotics, antivirals, antifungals and antiparasitics) to treat infections caused to humans, animals or plants.

Antibiotics are the best-known form of antimicrobials. These medicines are now very commonly used to treat bacterial infections in humans and animals which even in the recent past could have been fatal- and allow many medical procedures such as hip replacements and cancer treatments to take place safely. The work of the IOI mainly focuses on antibiotics.

Antimicrobial resistance is a normal- but worrying- phenomenon that happens as a result of evolution by natural selection. The microbes which harm us can, when not killed off in significant quantities, develop traits which help them to resist the effects of our medicines, and then reproduce to pass these traits on. This then creates drug resistant infections- commonly called “superbugs”.

Some of these infections can be very dangerous of themselves- and can also compromise our ability to conduct other important medical procedures, like standard surgeries, if they can no longer be effectively prevented or treated.

In recent years, the rate at which we have developed antimicrobial medicines- particularly antibiotics- has slowed to a halt, while the rate at which microbes have developed resistance to our arsenal of drugs has increased. As well as being driven by natural selection, this has been sped up by overuse and misuse of antimicrobials. Two examples of this are

  • Stopping a course of antibiotics before the treatment is complete. This allows the strongest bacteria still surviving to reproduce and pass on their resistant qualities, and the infection being treated can return and spread further.
  • Putting antibiotics in animal feed to promote growth and prevent infections in agriculture. While it is important for farmers to ensure that groups of animals don’t get and stay ill, unnecessary overuse allows microbes to develop resistance to common drugs- and those drugs used in animals are the same used to protect human lives.

The World Health Organisation has declared that AMR is one of the top 10 global public health threats facing humanity. It is predicted that by 2050, drug-resistant superbugs could claim 10 million lives a year (compared to around 8 million lives per year for cancer) and cost the global economy a cumulative US$100 trillion.

The thought of a future without effective antimicrobials such as antibiotics is terrifying, though we have only had these miraculous medicines for a few decades- a “golden age”. Only in 1924, Calvin Coolidge, President of the United States, lost his youngest son to a blood infection which developed from a blister caused by playing tennis. Within a week, the 16 year old was dead, despite having access to some of the best medical care of the time.

Unless we tackle the threat of AMR urgently, such occurrences will once again become common, and everyday medical procedures such as childbirth, surgeries, and even day to day accidents such as cuts and scrapes could carry high risk of fatality. Today, this is almost unthinkable- but could quickly become inevitable without timely investment in science to develop new drugs, and vastly improved management of the precious drugs we have.

Find out more about antimicrobial and antibacterial resistance below.

Reference

https://www.nature.com/articles/nrd.2016.160

https://amr-review.org/sites/default/files/160518_Final%20paper_with%20cover.pdf

https://www.who.int/news-room/fact-sheets/detail/antibiotic-resistance

https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance

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