‘It’s a pandemic’: Britain’s superbug envoy says scale of threat has been underestimated

The rising death toll from drug-resistant insects is “very frightening” and people don’t even realize it is happening, the UK’s Special Envoy for Antimicrobial Resistance (AMR) has said.

Superbugs kill more than a million people every year, but neither governments nor the public recognize the scale of the threat, doctors complain. The crisis is largely caused by the misuse of antibiotics – about 70% of which are given to livestock – which encourages the evolution of microbes too strong for modern medicine to handle.

“We need to use antibiotics safely and appropriately,” said Sally Davies, who resigned as England’s chief medical officer in 2019 to champion the UK’s fight against superbugs.

By 2050, drug-resistant insects are expected to kill nearly 2 million people annually and contribute to the deaths of 8 million. The figures put AMR in a similar ballpark to the Covid-19 pandemic, which the World Health Organization (WHO) estimates led to 4 million additional deaths in 2020 and 10 million in 2021.

Data published on Thursday showed a rise in the number of serious antibiotic-resistant infections in 2023 to 66,730 cases, above pre-pandemic levels. E.coli caused 65% of cases in Britain over the past five years.

“Some people talk about (AMR) being a pandemic – it is,” Davies said. ‘Is it a slow-moving one, an insidious one, or what? I don’t care what words you want to use, but it’s pretty awful.

World leaders have taken little action to reduce AMR-related deaths, but they pledged at the UN General Assembly in September to reduce them by 10% by 2030. Public health experts are frustrated by the lack of interest from governments and the lack of public awareness.

“It’s clearly a lack of priorities – and that must be a failure in our communications,” Davies said. “That’s partly the name ‘antimicrobial resistance’, AMR, partly the complexity, and the big part that’s hidden… they (doctors) don’t tell people what they’re dying from.”

Davies, who previously served on the WHO board of directors, lost her goddaughter to antimicrobial resistance two years ago. “It was terrible. She had cystic fibrosis, she knew she had AMR, and she knew she was going to die from it because it was infecting her lung transplant,” she said.

“She said to me, Sally, you’ve been working on this for years, you need to use my cause (to raise awareness). She was very brave.”

Doctors have urged people to do their part in the fight against the rise of superbugs by only taking antibiotics when prescribed and then taking the full course.

They also point out the major role that livestock farming plays behind the scenes. The growing appetite for meat is increasing demand for livestock and the use of antibiotics – some of which are used to treat animals that are not sick, sometimes as a substitute for keeping animals clean, Davies said.

“That encourages the development of resistance,” she said, “which can then be on the meat when it’s sold, and people pick it up that way. It can be passed on to slaughterhouse workers who go home to their families. And it certainly affects farmworkers and their families.”

Most antibiotics are flushed from an animal’s body through excretions, Davies said. “When you have high-intensity agriculture, you get antibiotics on the fields and in the runoff… They can end up in the groundwater. But it also turns out that the wind that comes with it can pick up bacteria and pieces of genes, take them into the sky and clouds and make it rain somewhere else.’

Antibiotic use in farm animals is correlated with antimicrobial resistance in humans, as a study showed last year. An “extremely high” E coli resistance of 73.3% to aminopenicillins, which are used in animals, but “very low” resistance of 0.78% to glycylcyclines, which are banned in livestock farming.

For S goldenthe researchers found a resistance to the macrolide group of antibiotics of 56%, while resistance to vancomycin, a more recent antibiotic that has been banned in livestock farming, was only 0.22%.

EU rules to encourage better farming practices have reduced the amount of antibiotics given to animals, with little impact on the industry. In Denmark, a leading pork producer, pigs consume one-fifth of the global average. In France, famous for its cheese, cows consume about a quarter of the average.

Alan Dangour, who leads the climate and health team at Wellcome, a non-profit research organisation, said scientists discovering new treatments were in a race against the bugs.

“It’s clear that if we don’t find a new set of antibiotics or responses to bacterial infections, more and more people will develop infections that no longer respond to the drugs we have,” he said. “That is very dangerous. “Imagine going back to a world before the invention of antibiotics, where people were dying left, right and center because they were circumcised… we don’t want to go back to that world.”