Superbugs will kill more than 39 million people by 2050, with older people at particular risk, according to a new global analysis.
While deaths from drug resistance are declining among very young children, thanks to improvements in vaccination and hygiene, the study found the opposite among their grandparents.
By mid-century, 1.91 million people a year are expected to die directly from antimicrobial resistance (AMR), when bacteria evolve to stop the drugs normally used to fight them from working. This is up from 1.14 million in 2021. AMR will play a role in 8.2 million deaths annually, up from 4.71 million in 2021.
The study, published in the Lancet was performed by the Global research into antimicrobial resistance (Gram) Project and is the first global analysis of AMR trends over time.
Researchers used data from 204 countries and territories to estimate the number of deaths between 1990 and 2021, and forecasts for the period up to 2050.
They also found that millions of deaths worldwide could be prevented through better infection prevention and access to health care, and through the development of new antibiotics.
Study author Dr Mohsen Naghavi from the University of Washington’s Institute of Health Metrics (IHME) said: “Antimicrobial drugs are one of the cornerstones of modern healthcare and increasing resistance to them is a major concern.
“These findings highlight that AMR has been a significant global health threat for decades and that this threat is increasing,” he said.
World leaders will meet in new york this month to discuss antimicrobial resistance at the UN General Assembly. They are expected to have a political impact declaration on stepping up action on antimicrobial resistance. Campaigners hope this will include a target to reduce deaths from AMR by 10% by 2030.
The study, which involved more than 500 researchers from institutions around the world, found that the number of deaths from AMR among children under 5 had fallen “remarkably” between 1990 and 2022, from 488,000 to 193,000. By 2050, this number is expected to halve again.
Although deaths from infections in young children are less common, the cause is increasingly being attributed to drug-resistant bacteria.
And the death toll is rising in all other age groups. The number of deaths from AMR among people over 70 has already increased by 80% in three decades and is expected to increase by 146% by 2050, from 512,353 to 1.3 million.
According to Dr. Tomislav Meštrović, assistant professor at the Northern University in Croatia and associate professor at IHME, the trend reflects the rapidly aging population, with older people being more vulnerable to infections.
“About three-quarters of AMR infections are linked to, for example, hospital infections, and a rapidly ageing population also requires more hospital care,” he said. Older people have more chronic diseases such as diabetes and heart disease.
“For example, if you put an IV in, it gets infected and bacteria get into the blood. Those bacteria are then likely to be more resistant,” he said.
Vaccination was often less effective in older people because the immune system He added that quality of life declines with age and older people are more susceptible to reactions to antibiotics.
The number of deaths from AMR was lower in 2021 than in 2019, but the researchers say this is likely only a temporary decline as there are fewer infections due to measures to control Covid-19.
The study found that the highest numbers of future deaths would occur in South Asian countries such as India, Pakistan and Bangladesh, but also in other parts of South and East Asia and in sub-Saharan Africa.
These areas are among those where AMR is already growing the fastest and where the greatest benefits can be achieved by improving overall infection control and expanding access to antibiotics.