The looming antibiotic emergency and why the time for global action is now

Imagine a world in which routine medical procedures often turn deadly from untreatable infections. Before the discovery of antibiotics, that was life. One in 20 children died before their first birthday. More than a third of all pneumonia cases were fatal. Common infections like cellulitis claimed lives.

What if the drugs and antibiotics we have come to depend on stopped working? That’s exactly the reality we step closer to every day.

AMR is a true emergency threatening to erase a century of global progress. Every year, common infections become harder to treat. Climate change drives temperatures higher, accelerating bacterial growth and worsening the crisis.

Without urgent, coordinated action, we risk a future that, in many ways, would be worse than the Covid-19 pandemic. And in some ways, it already is.

The Institute for Health Metrics and Evaluation estimates that AMR directly causes 1.5 million deaths each year and contributes to another 4.95 million deaths, with the greatest impact on people living in low- and middle-income countries (LMICs). For context, the Covid-19 pandemic caused about 3 million deaths in 2020, and during its peak in 2021, about 3.9 million.

On our current trajectory, the already considerable costs of AMR will only intensify. According to estimates by the World Bank, over the next 25 years, antimicrobial resistance is projected to cause 39.1 million deaths and reduce global gross domestic product (GDP) by 1.1–3.8 per cent, with cumulative costs reaching US$23.4-99.2 trillion,

Moving forward together

Experts agree that AMR is not just a human health issue – it’s a complex problem that affects agriculture, animal health, human health, and the environment, fuelled by drug-resistant bacteria that can move between animals and humans through water, soil, and food systems.

In September, the global community took an encouraging step forward. World leaders at the 78th United Nations General Assembly issued a political declaration recognising AMR as “one of the most urgent global health threats”.

Importantly, the declaration commits members to act toward key targets, including:

• By the end of 2025, establish an independent panel on AMR (like the Intergovernmental Panel on Climate Change for climate).
• By 2030, reduce global AMR-related deaths by 10 per cent.
• By 2030, ensure 70 per cent of human antibiotics use comes from the WHO Access group (a class of antibiotics with lower potential for resistance).

As one of many steps towards achieving these commitments, the UK’s Department of Health and Social Care hosted its first Global Antimicrobial Resistance Innovation Fund (GAMRIF) Summit this month.

GAMRIF is a fund that supports R&D around the world to reduce the threat of AMR in humans, animals, and the environment and this event will take place in Kuala Lumpur, Malaysia. Its research is primarily for the benefit of those in low- and middle-income countries but their products and findings are undoubtedly essential for the entire world.

AMR is a global issue. Many countries struggle with poor access to essential antibiotics, accurate diagnostics, and preventative vaccines, stretching already overburdened health systems. We need governments and the private sector to work together to invest in innovation and make sure that products reach communities across the world.

Everyone must act, and so can you. We must raise awareness of AMR’s threat and advocate for appropriate action. The fight against AMR requires:

• Better access to funding from existing multilateral and development sources
• Implementation of national action plans (only 10 per cent of national plans currently have sufficient funding).
• Better environmental management and waste treatment (managing human, animal, and environmental health together is essential).
• Research and innovation, including for smaller companies that now drive 90 per cent of antibiotic development.

The AMR crisis will not resolve itself. Without urgent, equitable action, the years ahead will look more and more like centuries past.

The time to act is now.

• Professor Dame Sally Davies is the UK Special Envoy on Antimicrobial Resistance (AMR) and former Chief Medical Officer (CMO) for England; Nikolaj Gilbert is president and CEO of PATH, an international nonprofit focused on advancing health equity through innovation and partnerships

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