AMR occurs when germs like bacteria, viruses and fungi evolve in ways that make the medicines used to treat them stop working. These germs can then cause resistant infections that can be difficult and sometimes impossible to treat.1

1.27M

deaths in 2019

AMR is a Growing Threat

In 2022, the Lancet Medical Journal published a study asserting that antibiotic-resistant infections were the direct cause of 1.27 million deaths and played some role in 4.95 million deaths in 2019.

This puts bacterial AMR as the third leading cause of death in 2019, after heart disease and stroke. If antibiotics and antifungals lose their effectiveness, then we lose the ability to treat infections and control these public health threats. But the challenge goes beyond treating infections – much of modern medical practice relies on preventive use of antibiotics for common surgeries and treatments. Increasing resistance means riskier procedures we take for granted now.2

By 2050, it is estimated AMR will cause more deaths than cancer unless concerted efforts are undertaken to counter its progression. 3

The Consequences of AMR

  • As the progression of AMR can render antibiotics less effective, common infections, such as wound infections, urinary tract infections and pneumonia will increasingly be associated with severe complications and increased risk of death.
  • Progress on reducing the fatality of childhood and maternal infections such as pneumonia and childbed fever could be reversed.
  • Common surgeries like c-sections and hip replacements can become much riskier. Non-vital surgeries could become difficult to justify due to the risk of resistant infection.
  • As chemotherapy causes immune suppression, cancer treatment could become substantially riskier.
  • With few options to treat potential infections, therapies that require immune suppression, such as organ transplants, could be untenable.4

Antibiotics and Cancer

Antibiotics are essential for effective treatment of several medical conditions, including cancer. According to the ReAct Group, effective cancer treatment has the highest risk of being impacted by anti-microbial resistance. AMR may not only affect the possibilities of treating cancer patients’ infections, but also what kind of cancer treatment can be offered.​ The risks of contracting resistant surgical site infections may outweigh benefits of surgery if infection treatment options are limited by AMR. There are also risks of untreatable bloodstream infections that must be balanced against the benefits of chemotherapy. Severe infections and sepsis are among the most frequent reasons cancer patients are admitted to intensive care units. It has been estimated close to one in ten cancer deaths is due to severe sepsis – not the cancer itself. One study found that 70% of cancer patients who initially received ineffective antibiotic treatment for bloodstream infections died within a month, compared to less than 20% of those who received appropriate antibiotics.

Tools to Combat AMR

Successfully fighting AMR requires a multipronged approach involving the following considerations:

Proactive Infection Prevention

Improved hospital-based infection control, hygiene, and sanitation can prevent infections and reduce the use of antibiotics. This can include the wider implementation of infection control units in hospitals to minimize the risk of infectious disease outbreaks within the hospital. Achieving higher vaccination rates can reduce the incidence of infectious diseases, which in turn decreases the unnecessary use of antibiotics and slows the development of AMR.5

Stewardship

Antibiotics are too often used inappropriately, such as for treating viral infections. Better understanding is needed among healthcare providers and patients on the proper use of antimicrobials to ensure they are used only when relevant, at the appropriate dose, and for the right amount of time. Further, promoting awareness around proper disposal of unused antimicrobials could mitigate their entry into the environment and help slow AMR. To be effective, core elements of antimicrobial stewardship must be embraced across all care settings, including hospitals, outpatient, low-resourced care settings, etc.

Collaboration

Involvement of a broad set of stakeholders is essential as no single actor or sector can effectively address the issue alone. AMR requires a collective effort and shared responsibility. This collaborative approach allows for the development of comprehensive strategies to prevent the emergence and spread of antimicrobial-resistant pathogens. For example, governments can contribute to the solution by participating in surveillance networks and data sharing, and fostering ongoing access to medicine by supporting global supply chains.

Access

Preserving the availability of a wide range of antibiotics is critical for ensuring doctors and patients have access to ideal treatment and avoid the suboptimal use of antibiotics. However, the sustained availability of some antibiotics is at risk due to unsustainable market dynamics. Many antibiotics are decades old and have been available as generics for years. In some cases, prices have dropped so low for these treatments that it is no longer viable for their manufacturers to continue making or selling them. With fewer companies making these drugs, there is a greater risk of shortages in the event of supply disruptions. To ensure continued access to a wide range of antimicrobials, we encourage policymakers and payers to foster a sustainable market for antibiotics, including older products.

Protecting Access to Antibiotics Public Policy Statement

Antimicrobial resistance (AMR) is a growing public health concern. Access to the right antibiotic at the right time is crucial in the fight against AMR, yet supply is threatened by the unsustainable market dynamics of off-patent antibiotics. Short- and long-term policy action is needed to safeguard access.

Read full issue brief

1. https://www.cdc.gov/drugresistance/about.html
2. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02724-0/fulltext
3. The Review on Antimicrobial Resistance – White Paper, 2014
4. ReAct Group
5. One Health Trust, The Value of Vaccines to Mitigate Antimicrobial Resistance, 2023