Superbugs will kill someone every three seconds by 2050 unless the world acts now, a hugely influential report says. The global review sets out a plan for preventing medicine “being cast back into the dark ages” that requires billions of dollars of investment.
It also calls for a revolution in the way antibiotics are used and a massive campaign to educate people. The report has received a mixed response with some concerned that it does not go far enough.
The battle against infections that are resistant to drugs is one the world is losing rapidly and has been described as “as big a risk as terrorism”. The problem is that we are simply not developing enough new antibiotics and we are wasting the ones we have.
Since the Review on Antimicrobial Resistance started in mid-2014, more than one million people have died from such infections. And in that time doctors also discovered bacteria that can shrug off the drug of last resort – colistin – leading to warnings that the world was teetering on the cusp of a “post-antibiotic era”.
The review says the situation will get only worse with 10 million people predicted to die every year from resistant infections by 2050. And the financial cost to economies of drug resistance will add up to $100 trillion (£70 trillion) by the mid-point of the century.
The review recommends:
- An urgent and massive global awareness campaign as most people are ignorant of the risks
- Establishing a $2bn ($1.4bn) Global Innovation Fund for early stage research
- Improved access to clean water, sanitation and cleaner hospitals to prevent infections spreading
- Reduce the unnecessary vast antibiotic use in agriculture including a ban on those “highly critical” to human health
- Improved surveillance of the spread of drug resistance
- Paying companies $1bn (£0.7bn) for every new antibiotic discovered
- Financial incentives to develop new tests to prevent antibiotics being given when they will not work
- Promoting the use of vaccines and alternatives to drugs
The review said the economic case for action “was clear” and could be paid for using a small cut of the current health budgets of countries or through extra taxes on pharmaceutical companies not investing in antibiotic research.
Lord Jim O’Neill, the economist who led the global review, told the BBC: “We need to inform in different ways, all over the world, why it’s crucial we stop treating our antibiotics like sweets.
“If we don’t solve the problem we are heading to the dark ages, we will have a lot of people dying. “We have made some pretty challenging recommendations which require everybody to get out of the comfort zone, because if we don’t then we aren’t going to be able to solve this problem.”
Eight years of hell
It is hoped the measures will prevent more people going through experiences like Emily Morris from Milton Keynes. She has regular urinary tract infections that do not respond to some antibiotics and could cause kidney damage or even death.
She says: “With every sting and every pain, my heart sinks at the thought of how many antibiotics I have left to use this time. “I’ve had the struggle of living with a resistance to antibiotics for nearly eight years of my life…there is a clear need for new antibiotics.”
Chancellor George Osborne said: “Apart from the moral case for action, the economic cost of failing to act is too great to contemplate. “So I am calling on other finance ministries to come together this year and, working with industry leaders and medical experts, agree a common approach.”
Exactly how to encourage the drugs industry to make new antibiotics has been a long running problem – there has not been a new class of antibiotics discovered since the 1980s.
A new antibiotic would be kept on the shelf for use in emergencies so a company could never make back its huge research and development costs. John Rex, from the antibiotics unit at AstraZeneca, said a new way of paying for drugs, as proposed in the report, was needed.
He argued: “Such models should recognise antibiotics as the healthcare equivalent of the fire extinguisher – they must be available on the wall at all times and have value even when used only infrequently.”
Lord O’Neill also focused criticism on agricultural practices that use antibiotics to boost the growth of animals, rather than to treat their infections. In the US, 70% of antibiotics (sold by weight) are for use in animals.
Despite being in animals, the practice risks spreading bacterial drug resistance to human infections as was witnessed with colisitin resistance last year. He also focused his ire on a lack of tests for infections that see people pointlessly given antibiotics for viral infections.
“I find it incredible that doctors must still prescribe antibiotics based only on their immediate assessment of a patient’s symptoms, just like they used to when antibiotics first entered common use in the 1950s,” Lord O’Neill said.
Bodies including the World Health Organization, the Wellcome Trust medical charity and the UK’s Royal Society all praised the report.
Former Italian Prime Minister Mario Monti said the findings were “definitely worth the urgent attention of global leaders”.
But Dr Grania Brigden, from the charity Médecins Sans Frontières, said: “This report is an important first step in addressing this broad market failure, it does not go far enough.”
MSF said infections resistant to drugs were a threat to their work around the world from the war-wounded in Jordan to newborns in Niger.
Dr Brigden added: “The O’Neill report proposes considerable new funding to overcome the failures of pharmaceutical research and development, but the proposals do not necessarily ensure access to either existing tools or emerging new products.
“Instead, in some cases, the report’s solution is simply to subsidise higher prices rather than trying to overcome them.”
Prof Colin Garner, the chief executive of the Antibiotic Research UK charity, said: “Looking at the problem globally has its drawbacks since monies must be found from many different sources to enact the recommendations, which takes time to do.
“It would have been good to see recommendations for new UK funds or government action which would tackle the current problem in the UK.
“It is fantastic that the O’Neill team have highlighted the challenges we face, but now we need to see action”, BBC reports