A deepening health crisis

The Coronavirus pandemic should act as a stark warning for policymakers on the growing threat to healthcare of Antimicrobial resistance, argue Martin Hojsík and Irena Joveva.

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In December 2019, a Chinese doctor warned of a potential outbreak of an infectious disease resembling SARS.

The local authorities in Wuhan downplayed his warning, and over the following months, the world’s media report on the rapid spread of Coronavirus and the increasing damage to the Chinese economy.

Several Asian countries have stopped importing Chinese animal- derived goods entirely, tourism is now marginalised and contracts are increasingly impossible to deliver.


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Despite the severity of the current COVID-19 outbreak, another potentially more dangerous health threat is receiving much less attention: Antimicrobial Resistance (AMR).

As the European Parliament indicated three years ago in its multi-stakeholder conference on the dangers of AMR, it was already Time To Act.

At the same time a special Parliament Magazine supplement warned about the further growth of deaths caused by AMR.

For several years, the European Commission continued to use the outdated mortality rate of 27,000 per year. Although this has been updated to 33,000 annually, it does not take account of all infections.

“If nothing is done, the EU and the world might face the horrifying dawn of a post-antibiotics era – with no surgical operations and even the smallest infections potentially lethal”

Hospitals are a critical source of AMR, yet it is still not legally binding that all EU Member States report on the level of resistant infections through the European Antimicrobial Resistance Surveillance Network (EARS-Net), while nurses are not allowed to personally report AMR cases.

Sales of antibiotics remain high and little evidence was found by the Court of Auditors in November 2019 that the Commission’s activities would reduce the health burden caused by AMR.

Antimicrobial resistance is a persistent and growing threat to healthcare around the globe; Japan recently reported that over half a million people have been infected with multiple-resistant bacteria.

China, meanwhile, has informally reported around a dozen outbreaks of multiple or totally resistant bacteria per year.

The huge lack of hygiene in animal husbandry and fish farms all over Asia and particularly in China is a significant factor in pathogenic outbreaks, whether resistant or not, and it has decimated pork production, one of China’s core foods, through another viral outbreak: African Swine Fever.

The latter has left the country with a mere 30 percent of its live pork stocks, forcing China to open its wartime reserves. The consequent price rises and increased pork imports have pushed Chinese people to switch to chicken.

“As life-saving antibiotics stop being effective, AMR could end our capacity to combat infections”

However, to produce sufficient poultry for 1.3 billion people placed such enormous strain on production, imports and prices that another pathogenic outbreak occurred; this time of a new strain of bird flu in China’s central Hunan province, right next to the epicentre of the current Coronavirus outbreak.

Around 18,000 chickens were reportedly culled following an outbreak of a new and “highly pathogenic subtype” of the H5N1 flu, according to the Chinese Ministry of Agriculture and Rural A airs.

This strain on the husbandry system, combined with poor hygienic practices, will most likely lead to a further increase in AMR outbreaks.

According to environmental health and justice campaign group ‘Health Care Without Harm, between 1999 and 2017 around 400,000 European families mourned AMR-related deaths. Globally, drug-resistant infections already claim at least 700,000 lives a year, including 230,000 from drugresistant tuberculosis.

By 2050, resistant infections could kill an estimated 10 million people annually and cause an economic slowdown comparable to the global financial crisis of 2008.

As life-saving antibiotics stop being effective, AMR could end our capacity to combat infections. If nothing is done, the EU and the world might face the horrifying dawn of a postantibiotics era – with no surgical operations and even the smallest infections potentially lethal.

This is all the more important since a relationship between global warming and the emergence of AMR has just been established.

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