In the UK and beyond, a silent crisis is escalating that could see us returning to a time when minor infections were deadly. The culprit? Antimicrobial resistance (AMR). As this growing threat looms, experts warn that the world is at risk of losing one of the greatest achievements of modern medicine—antibiotics.
The Crisis of Antimicrobial Resistance
Imagine cutting yourself while preparing dinner. Normally, a plaster and some antiseptic would be enough, but what if the wound became infected and no antibiotics could help? This isn’t a far-fetched scenario; it’s one that could soon become a grim reality due to AMR.
Antimicrobial resistance occurs when bacteria, viruses, fungi, and parasites evolve to outsmart the medicines designed to kill them. As a result, antibiotics, once hailed as “miracle drugs,” are becoming increasingly ineffective. The consequences could be devastating. By 2050, experts predict that AMR could lead to 39 million deaths globally, with 2 million fatalities in India alone. Moreover, the financial burden could skyrocket, with global healthcare costs surging by $159 billion annually.
How We Got Here: A Brief History
To understand the severity of the situation, it’s crucial to look back at the origins of antibiotics. Discovered accidentally by Alexander Fleming in 1928, penicillin revolutionised medicine. Suddenly, infections that had once been fatal could be easily treated, and medical procedures like surgeries and organ transplants became much safer.
But over time, antibiotics were overused. Doctors began prescribing them for illnesses that didn’t require them, such as viral infections, which antibiotics can’t treat. Additionally, in the 1950s, antibiotics were widely introduced into animal farming, not only to prevent disease but also to accelerate growth. This misuse in both humans and animals has driven the evolution of drug-resistant bacteria, or “superbugs.”
The Rise of Superbugs
Today, these superbugs pose a significant threat, especially in countries like India where antibiotics are often available without a prescription. Pharmacies routinely sell these medications over the counter, and some doctors, incentivised by pharmaceutical companies, prescribe them too freely.
In low and middle-income countries (LMICs), the problem is particularly severe. Hospitals, meant to heal, are becoming breeding grounds for drug-resistant infections. Surgical patients in these regions face a 11% chance of developing life-threatening infections, directly linked to AMR. And in countries with underfunded healthcare systems, infections like sepsis are spreading unchecked.
Take the example of Nigeria, where a newborn with sepsis couldn’t be treated with standard antibiotics. The medical team had to resort to one of the most powerful antibiotics available, meropenem, though even that wasn’t guaranteed to work. This tragic situation is being mirrored in conflict zones like Ukraine, Gaza, and Sudan, where infections go untreated due to a lack of effective drugs.
Why Aren’t New Antibiotics Being Developed?
With the stakes so high, one might wonder why pharmaceutical companies aren’t rushing to develop new antibiotics. The answer is largely economic. Developing a new antibiotic can take 10 to 15 years and cost more than a billion dollars. Antibiotics are also considered a last resort, meaning doctors are reluctant to prescribe them frequently, fearing that overuse will hasten resistance.
To make matters worse, antibiotics are sold at relatively low prices, which means companies struggle to recoup their investment. As a result, many big pharma companies have scaled back or exited the antibiotics market altogether.
Hope on the Horizon: Efforts to Combat AMR
Despite the bleak outlook, there are efforts underway to address antimicrobial resistance. In India, for example, Wockhardt is preparing to launch Zaynich (WCK 5222) by 2025 to combat multi-drug resistant (MDR) and extensively drug-resistant (XDR) pathogens. Globally, companies like GSK, Pfizer, and Merck are investing in the development of new antibiotics. Basilea Pharmaceutica, for instance, is focused on creating treatments for hospital-acquired infections, a major contributor to AMR.
On an international scale, initiatives like the AMR Action Fund aim to bring 2-4 new antibiotics to market by 2030. In the U.S., the Department of Health and Human Services (HHS) is funding the TARGET Project, which uses artificial intelligence (AI) to accelerate the discovery of new treatments.
The Long Road Ahead
While these efforts are encouraging, the real challenge lies in making antibiotic development sustainable. If we fail to do so, AMR could push us back to a pre-antibiotic era, where even minor infections could become fatal.
The fight against AMR requires global cooperation. No single country can tackle this crisis alone. It demands stronger regulations on antibiotic use, increased investment in drug research, and widespread public awareness about the dangers of antibiotic misuse.
The clock is ticking, and without urgent action, we may face a future where life-saving medicines are no longer effective. The threat is real, but with concerted global efforts, it’s not too late to stop AMR in its tracks.
