SEATTLE — The misuse of antibiotics has the potential to reset the clock on decades of medical progress. The antimicrobial resistance crisis has spread worldwide, requiring urgent action from international authorities.
Antimicrobial resistance, or AMR, is an unintended consequence of the usage of antibiotics, antivirals and antifungals. Put simply, AMR is a resistance developed in the microorganisms that cause disease, making the standard medications for that disease ineffective.
Exemplifying natural selection, the resistant microorganisms replicate themselves and transfer the drug-resistant genes horizontally to the other microorganisms, increasing the abundance of the resistant strain of the species.
There is a direct correlation between the misuse of antibiotics and the emergence of resistant strains of bacteria. As the antibiotics kill the bacteria that are sensitive to the drug, the resistant bacteria are left behind, leaving them to replicate, spread and infect.
After an analysis of data from 114 countries, the WHO has reported that the antimicrobial resistance crisis is not a fear of the future, as it is happening now – in every region of the world.
The impact of antimicrobial resistance is devastating. At the largest scale, it endangers the ability to treat even the most common infectious diseases. This results in millions of deaths worldwide that could have been easily prevented.
Even if new antibiotics are developed as replacements, they are less efficacious and more expensive. Before too long, the bacteria will evolve to be resistant to the new drug as well.
Antibiotic use in livestock, for the maximization of quality, growth and yield, also contributes to the crisis. When the livestock is consumed, the antibiotics are ingested, spreading antimicrobial resistance.
From nutrition centers in Nigeria to trauma units in Syria, the horror of antimicrobial resistance is felt worldwide. Due to a lack of understanding about the function of antibiotics, the drugs are often overprescribed, incorrectly prescribed or inappropriately used by the consumer. In many countries, antibiotics are so plentiful, they are even sold cheaply over the counter.
Gonorrhea treatment has failed in 10 countries according to the WHO, suggesting that the infection could become completely untreatable in the future. Resistance pneumonia treatments, such as carbapenems and penicillin, have been found to exceed 50 percent in some areas.
Perhaps most alarmingly, the epidemics that the medical system has worked so hard to mitigate – such as tuberculosis, malaria and HIV – are now displaying higher resistance to treatment.
For HIV, pre-treatment resistance rates were at 22 percent in 2010, a number that has only subsequently increased. Multi-drug resistant tuberculosis accounts for 20.5 percent of tuberculosis infections. In Myanmar, Cambodia and Vietnam, antimalarial resistance is on the rise.
In the past, from the 1960s to the 1980s, pharmaceutical companies would introduce another drug when resistance for the previous had evolved. Now, while antibiotics continue to be vital in medical practice, the majority of the industry has abandoned the development of antibiotics, as the drugs are less profitable than the drugs for chronic conditions.
In order to fully combat the global antimicrobial resistance crisis, international organizations need to intervene with urgency and extremity.
On September 21st, the U.N. will hold a General Assembly, calling on world leaders to address the efficacy of antimicrobial medication. This is the third time the U.N. has convened on a health issue, preceded only by assemblies on AIDS in 2001 and Ebola in 2014.
The Center for Disease Dynamics, Economics and Policy suggests that policymakers, health workers and the public all need to be further educated on appropriate antibiotic use, through massive public awareness campaigns to change misperceptions.
Additionally, to reduce the exposure to antibiotics, hygienic infrastructure needs to be improved, vaccinations need to be developed and agricultural antibiotic use needs to be halted.
Many specialists consider the antimicrobial resistance crisis to be as damaging as global warming. Many call for a complete phase out of antibiotics, similar to the international response to asbestos and chlorofluorocarbons. The evidence for the danger of the misuse of antibiotics is clear – all that’s needed now is a coordinated international response.
– Larkin Smith