By Angus Dalton
Almost 40 million people will die directly because of drug-resistant infections by 2050, a huge global analysis has found, as scientists warn of a return to the “dark ages” of medicine where minor infections kill, and routine surgery turns deadly, due to a lack of effective antibiotics.
Drug-resistant bugs will also be indirectly implicated in the deaths of a further 169 million people, the study predicted. The paper in The Lancet is the first-ever global analysis of trends underpinning deaths caused by antimicrobial resistance (AMR).
Some strains of E. coli have evolved resistance to some, if not all, available antibiotics.Credit: Wikimedia
While the number of children killed by AMR halved between 1990 and 2021, deaths in people older than 70 spiked by 80 per cent. That’s created a trajectory whereby overall fatalities will increase by 70 per cent by 2050 as superbugs evolve resistance to multiple drugs.
The study was released in the lead-up to the UN General Assembly’s high-level meeting on AMR next week in New York, where countries will be urged to sign a political declaration committing to reduce deaths by 10 per cent by 2030 rather than let drug-resistant infections run rampant.
Professor Branwen Morgan leads the CSIRO’s quest to reduce microbial resistance and will attend the talks. She said humans turbocharged microbial evolution by producing the drugs that kill them at scale since World War II.
“Bacteria and microbes evolve pretty quickly, and anything you throw at them, they’re going to find a way around,” she said. “The more we use antibiotics, the faster we’re going to lose them.”
A hundred deaths a week are associated with antimicrobial resistance in Australia, according to a new resource launched by the CSIRO and other collaborators called AMR Action & Insights.
The site warns we may “return to the dark ages of medicine where surgery becomes inherently risky, and currently treatable infections and injuries kill once again”.
The financial incentive for pharmaceutical companies to produce new antimicrobial drugs has crashed because developers baulk at the prospect of new drugs rapidly becoming obsolete as microbes evolve resistance. The fact most antibiotic courses only last a week or two also limits profitability.
That’s why the UK has implemented a “Netflix” model of regularly paying manufacturers to keep the drugs coming regardless of how many antibiotics actually get sold.
Meanwhile, University of Sydney infectious disease expert Dr Justin Beardsley criticised The Lancet analysis for not including fungal infections, which kill at least 3.8 million people a year.
Beardsley also sounded the alarm earlier this year when a fungicide used to kill mould on strawberries was approved for use in Australia with the same mechanism as a precious new antifungal drug, olorofim.
The deadly fungus olorofim treats might gain resistance to the drug before it even hits pharmacy shelves, he said.
The bungle underscored how the “One Health” philosophy – whereby the health of people, animals and the environment is considered a unified whole – is critical to tackling antimicrobial resistance.
“It’s a failure of One Health thinking, a failure to link up the different executive arms in government. It’s a problem that the pesticide people are not talking to the human health people,” Beardsley said.
“It’s not that anybody sets out to be that way. It’s just that the systems are not designed in a way that facilitates that cross talk.”
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