The Guardian view on antimicrobial resistance: we must prioritize this global health threat | Editorial
aAccording to apocalyptic horror stories, these are among the scariest. Yet it is not fiction writers, but top scientists who warn about what the world could look like if superbugs develop resistance to the remaining drugs against them in our hospital pharmacies. Patients who can currently be cured will die; routine operations will become dangerous or impossible. Antimicrobial resistance (AMR) – which occurs not only in bacteria but also in viruses, fungi and parasites – is one of the greatest global public health threats facing humanity. says the World Health Organization (WHO). It kills 1.3 million people and contributes to 5 million deaths annually, expected to reach 10 million by 2050. In addition to the terrible human toll, this will increase pressure and costs on the healthcare system. But is it high enough on the agenda? Covid-19 put an end to it and the climate crisis is getting more attention. AMR doesn’t get top billing very often.
This week, efforts were made to change that talks at the UN This leads to wider reporting documenting the dire state we find ourselves in. From the pharmaceutical industry to the WHO and NHS England the same tune is being played: we are not doing enough to prevent disaster.
Dame Sally Davies, Britain’s former chief medical officer and now the UK’s special envoy for AMR, told the Guardian that resistance could make the Covid pandemic seem ‘small’. Tragically, her goddaughter, who received a double lung transplant for cystic fibrosis, died at age 38 from an antibiotic-resistant infection. Low- and middle-income countries will be hardest hit. But those who think this is a developing world problem should think again.
This is a multi-faceted problem. There is no quick fix. Antibiotics are still used too much and incorrectly. They do not work against viruses that cause coughing and if you are prescribed them it is essential that you complete the course otherwise a resistant strain of bacteria may develop. Staggering amounts – two-thirds of all antibiotics – are used in agriculture, to keep animals healthy. While responsible individuals must do their part, it is clear that coordinated intergovernmental action is needed on all fronts.
We must cherish the antibiotics we have and use them sparingly. And we desperately need more. Only ten new antibiotics were approved between 2017 and 2023. This is reported by the international pharmaceutical trade organizationof which only two are considered innovative by the WHO and none are a new class of antibiotics. In January, US scientists said they had found a molecule that worked in a new way against one of three highly drug-resistant bacteria considered the biggest threat to human health – but so far the drug has only been tested on mice.
Hopefully it will go further, but the companies are busy making money. New antibiotics are hoarded by the day the old ones no longer work. So there is no lucrative market. Economist Jim O’Neill proposed a prize fund to pay pharmaceutical companies for developing new antibiotics. The NHS tested exactly this thing, rewarding two companies with lump sums of £10 million per year instead of paying for ordered packs of pills. Other countries, including Japan and the US, are exploring the idea. More people need to get involved and move the pharmaceutical industry in the direction we need it to go.
This week’s interest comes as a prelude to a UN general meeting on AMR in September, aimed at persuading governments around the world to step up efforts. Whatever happens in the meantime – from wars to pandemics – nothing should stop them from dedicating themselves to a new and determined focus on one of the most critical issues of our time.