Antibiotics are the cornerstone of modern healthcare. In addition to successfully treating infectious diseases, they are critical to ensuring patient safety during millions of routine in-hospital procedures, ranging from organ transplants and joint replacements through to chemotherapy and pre-natal care.
However, as WHO director-general Margaret Chan told a global health conference earlier this year, the steadily growing threat of antimicrobial resistance (AMR) means that we risk entering “a post-antibiotic era in which common infections will once again kill” – an era that would be “the end of modern medicine as we know it”.
Dr. Chan described the failure of more and more “mainstay antimicrobials” as one of the three main health-related threats facing the world today, together with the rapid increase in chronic non-communicable diseases and the health consequences of ongoing climate change.
A recent report, cited by Dr. Chan, estimates that the uncontrolled spread of AMR could lead to an additional 10 million deaths annually by 2050. That’s approximately three times the number of people who currently die annually from tuberculosis, HIV and malaria combined.
For infectious diseases, you cannot trust the past when planning for the future.
The Centers for Disease Control and Prevention (CDC) are also clear about the challenge: “...these drugs have been used so widely and for so long that the infectious organisms the antibiotics are designed to kill have adapted to them, making the drugs less effective.”
AMR is not a new phenomenon: the discoverer of penicillin, Alexander Fleming, warned in his Nobel Prize acceptance speech in 1945 that overuse of antibiotics would result in increased bacterial resistance to the new “super-drugs”. And AMR is not confined to antibiotics; in addition to antibiotic resistance, resistance is also growing to medicines that treat other microbes, including parasites (e.g. malaria), viruses (e.g. HIV) and fungi.
The good news is that it’s not too late to do something – provided we act quickly, and in a coordinated global fashion.
Rex Clements, global head of Anti-Infectives at Sandoz, explains: “If we are to have an impact, we need to work together in a cross-sectorial way, and we need to act on three related fronts: research, responsible use of medicines (stewardship) and responsible manufacturing.
We need to act on three related fronts: research, responsible use of medicines (stewardship) and responsible manufacturing.
“First, we need to discover and develop novel antibiotics. However, Research & Development can take years and requires significant financial investments, so there is also an urgent need for more immediate solutions. Which leads us to the second area for action: stewardship. Stewardship essentially means the promotion of guidelines to ensure that antibiotics are used properly, appropriately and only when they are really needed. And, last but by no means least, we need to drive the global adoption of responsible manufacturing practices and secure supply, including proper environmental controls.”