“If we use antibiotics when not needed, we may not have them when they are most needed.” -Tom Frieden, MD, Former Director U.S. CDC
WHO defines antibiotics as the medicines used to prevent and treat bacterial infections. Antimicrobial resistance (AMR) or antibiotic resistance (AR) occurs when bacteria and other microorganisms learn to resist the medications meant to inhibit them. In simple words, it means that the bacteria that cause disease in humans and animals alike, become untouchable by the medicines they take.
Ever since the discovery of the first Antibiotic Penicillin in 1929, we have entered a new age in human health. They have become the foundation of the healthcare system worldwide and are the principal constituent for the treatment of many diseases. However, many factors have led to the evolution of antibiotic-resistant pathogens, meaning bacteria have started evolving to become resistant to these drugs. The “golden age” of antibiotics is now over. The overuse and abuse of these drugs, as well as the lack of new drug development as a result of diminished economic incentives and difficult regulatory requirements, have all been linked to the crisis of antibiotic resistance.
Gwen Knight, Co-Director of the AMR Centre, describes Antibiotic Resistance as “more of an aspect of disease than a disease in itself.” So why exactly is this resistance against antibiotics so worrisome to many researchers and healthcare experts in the world?
Well, because antibiotic resistance has become a globally recognized public health emergency. The Global action plan on antimicrobial resistance published by WHO in 2016 asserts that “Antimicrobial resistance threatens the very core of modern medicine and the sustainability of an effective, global public health response to the enduring threat from infectious diseases.” Every single nation in the world is at risk of healthcare collapse due to AR.
It has been discovered that bacterial AR was directly responsible for 1.27 million deaths in 2019 and it is linked to more than twice the number. This shows that AR killed more people than Malaria (643,000 deaths) or even AIDS (864,000 deaths). According to a 2016 review on antimicrobial resistance, by the year 2050, AR may be responsible for up to ten million annual deaths worldwide. With the increasing cases of antibiotic resistance worldwide, scientists and healthcare researchers have already warned that even curable and mild infections will become incurable if immediate action is not taken. They have the potential to have an impact on the healthcare, veterinary, and agricultural sectors as well as on people at any stage of life. In addition to the inappropriate use of antibiotics, some of the leading causes of this phenomenon are:
- Natural resistance bacterias develop to antibiotics over time.
- Inappropriate prescribing of drugs by doctors.
- Extensive agricultural use (used for livestock and poultry).
- Availability and discovery of few new antibiotics since the 1960s.
- Regulatory barriers and over-the-counter uses of the drugs.
- Use of antibiotics for Viral diseases.
These make the phenomenon one of the world’s most urgent public health problems.
Along with the public health crisis Antibiotic resistance has presented the world with, it also has a serious economic burden. Infections that are resistant to antibiotics incur significant costs for the country’s healthcare system, which in most cases, is already overburdened. In cases where infections are treatable even with the resistant strain present, they are usually far more expensive and lead to longer hospital stays and repercussions, along with an increased chance of long-term disabilities. According to recent World Bank research, antimicrobial resistance will affect low-income countries more than the rest of the world and increase the rate of poverty.
The gap between developing and developed nations will also widen as a result of AR, with a substantial increase in inequity. In particular, people from low-income nations will make up the majority of those who are forced into extreme poverty as a result of AMR. This emphasizes how the poorest people in the world will ultimately be the most impacted because their economies depend more on labor, which will suffer from a high prevalence of infectious diseases.
As the world hasn’t even fully recovered from the dark days of COVID-19, experts have desperately started warning us that antibiotic resistance could be one of the biggest threats to humanity, while some already calling it “the hidden pandemic.”
Next step forward?
The effect of antibiotic resistance harms everyone, hence a global approach is needed to challenge it. Policies to inform and encourage behavioral changes in the prescription and use of antibiotics can strengthen AMR defense systems. Experts have concluded that working as a society and individuals to reduce our reliance on antibiotics by increased access to proper hygiene, sanitation and awareness is a key to fighting AR. Every individual, health care workers, and the entire industry, policymakers, are equally responsible to optimize the use of antibiotics and ensure sustainable methods to counter this problem.
Some key ways to counter the problem are:
- Using antibiotics when prescribed by a certified health professional.
- Strengthening policies, programs, and implementation of infection prevention and control measures against antibiotic resistance.
- Reporting antibiotic-resistant infections to surveillance teams by health care workers.
- Investing in research and development of new antibiotics, vaccines, diagnostics, and other tools.
The data on death tolls of antibiotic resistance, the scientific papers on the impact of the phenomenon, and the discussions of its effect in the future are a grim reminder that we are already living through an “Invisible pandemic” and it will take no time for it to become a bigger threat to the public health and world economy. If the COVID-19 pandemic has taught us anything, it is that our healthcare system is not yet well equipped to combat another pandemic with a threat as big as this. But it is high time that we take some action immediately. Because if we don’t, it will be too late. We cannot afford not to.