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HealthGlobal issues

The global threat of antimicrobial resistance

Derrick Wiliams
December 21, 2023

Drug-resistant pathogens directly kill or contribute to the deaths of an estimated 5 million people every year. Many have grown resistant to the most effective medicines, and developing alternatives is growing critical.

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Antimicrobial resistance affects us all, because anyone could at some point be infected by potentially deadly common microbes that no longer respond to the medicines we use to treat them. Globally, drug-resistant pathogens already kill more people than either HIV/AIDS or malaria. It's a trend that has experts very worried.

"It's getting worse. Antibiotic resistance is rising. If we don't do anything now, we will have a post-antibacterial era by 2050," said Lesley Ogilvie of the German Center for Infection Research.

The most direct threat to human health is posed by antibiotic resistant bacteria — often called "superbugs." The WHO has identified "priority pathogens" — among them drug-resistant Clostridium difficile, which can cause life-threatening diarrhea, as well a drug-resistant strain of the bacteria that causes gonorrhea. Half a dozen others are even more deadly.

"If you combine all of those six pathogens, they're responsible for close to 75% of all deaths attributable to drug-resistant infections in 2019. Bloodstream infections, pneumonia, meningitis — these are the leading diseases that are causing problems," said Ogilvie.

But antibiotic-resistant bacteria are just one aspect of the issue. Viruses — among them HIV — can also grow unresponsive to the drugs used to treat them, as can parasites like the plasmodium that causes malaria. And doctors are also now seeing many more fungal infections that were once easily treatable acquiring resistance to conventional medications. Resistance can develop very fast.

"If a new antibiotic was introduced for use right, right now, today, on average we would see reports of resistance in about two to three years. But in the lab, you'll see this in 11 days or something like that for certain antibiotics," said Ogilvie. "I think we have to remember it's a natural evolutionary process. And this is accelerated by the misuse and overuse of antimicrobials. We can't stop it, but we can slow it down."

In the evolutionary arms race with enemies that are too tiny to see with the naked eye, the situation is growing critical. We have to develop new antibiotics and other treatments — and use the ones we already have more wisely.