What is antimicrobial resistance?
AMR occurs when microbes – bacteria, fungi, parasites and viruses – evolve to the point where antimicrobial drugs that previously worked against them are no longer effective. As a result of this drug resistance, infections spread and become harder to treat.
Africa is likely to bear the heaviest burden of AMR.Image: The Lancet
Some strains of bacteria have become “superbugs”, developing resistance to multiple forms of treatment. These include MRSA (methicillin-resistant Staphylococcus aureus), Clostridium difficile (C. diff) and the bacteria that cause multi-drug-resistant tuberculosis.
AMR affects all countries, although some are feeling the impact more than others. In particular, Sub-Saharan Africa may bear a particularly heavy burden. However, there is currently a lack of high-quality data on AMR and infectious diseases in low-income areas, researchers say.
How does antibiotic use affect resistance?
Excessive antibiotic use is a significant driver of resistance. If the treatment is too short, weak, or incorrect for the infection, we risk leaving behind resistant microbes. The more we expose microbes to antimicrobials and/or other resistant microbes, the more opportunities we create for resistance to develop and multiply.
And it’s not just prescribing to humans that is a problem – two-thirds of antibiotics globally are used in farming. Low-level antibiotics are routinely used for prolonged periods, even in healthy animals, to stave off disease and promote livestock growth. In recent years, antibiotic use in agriculture in Europe has fallen dramatically. But they continue to be widely used elsewhere, particularly in Brazil, China and other emerging countries, because of their impact on profit margins and a lack of viable and affordable alternatives.
How can we turn the tide on AMR?
Global coordination is needed to both tackle the rise of antimicrobial resistance as well as foster the development of new drugs. We must also work together to ensure healthcare systems worldwide are prepared for rising resistance and infection levels.
Working with BCG, the Wellcome Trust and the Novo Nordisk Foundation, the Forum has produced a report highlighting how we can promote antibiotic research and development globally. One possible solution is to introduce a subscription payment model to create a regular revenue stream and offset investment costs associated with drug development.
World AMR Awareness Week is an annual global campaign to raise the profile and understanding of AMR. A World Health Organization initiative, it aims to promote best practices among the public and policymakers, who all have a crucial role to play in reducing the emergence and spread of AMR.
In September 2023, Defeating Antibiotic Resistance through Transformative Solutions (DARTS) was announced by President Biden It uses artificial intelligence, high-throughput testing and robotics to develop rapid platforms to test for antibiotic resistance.
DARTS was the brainchild of Johan Paulsson, a Harvard Medical School microbial biophysicist, after experiencing an infection that caused his organs to start failing, but for which the microbe responsible was never identified.
The $104 million project seeks to discover how bacteria evade medicines, develop new antibiotics and diagnose infections and antimicrobial resistance efficiently and affordably, according to Nature.
Website: International Conference on Infectious Diseases.
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