Antimicrobial resistance
Critical interventions to address AMR threat
More than 39 million deaths from antibiotic-resistant infections are predicted between now and 2050, according to the latest analysis. This month, World Antimicrobial Resistance (AMR) Awareness Week seeks to raise awareness of this existential threat to humankind. So, what action must be taken on a national and global level?
More than 39 million people around the world could die from antibiotic-resistant infections over the next 25 years, according to a study published in The Lancet.1
The new study by the
Global Research on Antimicrobial Resistance (GRAM) Project is the first global analysis of antimicrobial resistance (AMR) trends over time. It reveals that more than one million people
died each year as a result of AMR between 1990 and 2021. The study also estimates 1.91 million people could potentially die as a direct result of AMR in 2050, an increase of almost 70% per year compared to 2022. Over the same period, the number of deaths in which AMR bacteria play a role will increase by almost 75% from 4.71 million to 8.22 million per year. Between 1990 and 2021, AMR deaths among
children under five years old declined by 50%, while those among people aged 70 years and older increased by more than 80%. These trends are predicted to continue in the coming decades, with AMR deaths among children under five projected to halve by 2050 globally, as deaths among people 70 years and older more than double. The findings highlight a vital need for interventions that incorporate infection prevention, vaccination, minimising
inappropriate antibiotic use, and research into new antibiotics to mitigate the number of AMR deaths that are forecasted for 2050. “Antimicrobial medicines are one of the
cornerstones of modern healthcare, and increasing resistance to them is a major cause for concern. These findings highlight that AMR has been a significant global health threat for decades and that this threat is growing. Understanding how trends in AMR deaths have changed over time, and how they are likely to shift in future, is vital to make informed decisions to help save lives,” said study author Dr. Mohsen Naghavi, Team Leader of the AMR Research Team at the Institute of Health Metrics (IHME), University of Washington, US. Already widely recognised as a major global
health challenge, AMR – which occurs when bacteria or other pathogens change in ways that make them evolve to no longer respond to antimicrobials – is anticipated to worsen in the coming decades. However, until now, no studies have assessed historical trends of AMR and provided in-depth forecasts of future global impacts. The first GRAM study, published in 2022, revealed the true scale of AMR for the first
time. It found that global AMR-related deaths in 2019 were higher than those from HIV/AIDS or malaria, leading directly to 1.2 million deaths and playing a role in a further 4.95 million deaths.2 Estimates for the new GRAM study were
produced for 22 pathogens, 84 pathogen-drug combinations, and 11 infectious syndromes (including meningitis, bloodstream infections, and other infections) among people of all ages in 204 countries and territories. The estimates were based on 520 million individual records from a wide range of sources, including hospital data, death records, and antibiotic use data. Statistical modelling was used to produce
estimates of deaths directly from AMR and those in which AMR played a role. Based on the historical trends calculated, the authors estimate the most likely global and regional health impacts of AMR from 2022 until 2050. Estimates were also produced for scenarios in which healthcare quality and access to antibiotics improve in the future and drug development targets Gram-negative bacteria.
Shifting global trends Their findings reveal that more than one million lives were lost each year from 1990 to 2021 as a direct result of AMR. In 1990, there were 1.06 million deaths directly due to AMR of a broader 4.78 million associated deaths. In 2021, AMR led directly to 1.14 million deaths and was associated of a broader 4.71 million deaths. AMR deaths in 2021 were lower than in 2019 (1.27 million direct AMR deaths; 4.95 million associated deaths) due to reductions in the burden of non-COVID lower respiratory infections, likely caused by social distancing and other disease control measures in place during the COVID-19 pandemic. The team’s analysis suggests this decline in AMR deaths was only temporary. Over the three decades, trends in AMR deaths underwent a major age-related shift, with those among children under five years old decreasing by more than 50% (59.8% reduction in direct AMR deaths, 488,000 to 193,000 deaths; 62.9%
50
www.clinicalservicesjournal.com I November 2024
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