Ambulance sirens loom in the distance; hospital admission units are overwhelmed, while doctors and nurses in full personal protection gear frantically fight to save patients’ lives in intensive care units. The year is 2050 and there is yet another outbreak of a food-borne disease hitting the city, affecting thousands of patients; the culprit is a super resistant strain of E. Coli.
Although this is a hypothetical scenario, our future may look exactly like this if we fail to act in time. By the middle of the century, it is estimated that more than 10 million people will lose their lives each year from Antimicrobial Resistance (AMR) related diseases.
For almost a year now, we have borne witness to what a full-blown global health crisis looks like. The COVID-19 pandemic is responsible for more than a million deaths, worldwide economic depression and drastic containment measures being put into place.
“Imagine that 2020, with all its upheaval, becomes the norm in a future where we will have lost the fight against antimicrobial resistance”
Imagine that 2020, with all its upheaval, becomes the norm in a future where we will have lost the fight against antimicrobial resistance. Fighting AMR is not an easy task, and the current COVID-19 pandemic has only made things worse.
A report by the WHO has shown that, due to the high number of hospital admissions caused by the ongoing pandemic, there is an increased risk of healthcare-associated infection and the transmission of multidrug-resistant microorganisms. This in turn leads to an increased use of antimicrobial medication.
Widespread use of biocidal agents outside healthcare settings, such as hand sanitisers for personal disinfection, are yet another factor that can lead to the proliferation of drug-resistant bacteria strains in the environment. Amid all this chaos, however, there is also a silver lining: greater public understanding, acceptance and compliance with prevention and control measures, like frequent hand washing and social distancing.
Increased public awareness regarding the mechanisms of disease transmission and the importance of prevention are benefits that can be attained in our fight against AMR and other disease outbreaks. Lessons learned now will be invaluable in better coping with the prevention and control of future health crises, such as the silent pandemic of AMR, which is growing by the year.
Microorganisms’ resistance to treatment continues to spread in our environment, in our living spaces and healthcare facilities, hopping from one host to another, animal and human alike. Prevention and containment of deadly, antimicrobial resistant bacteria needs to be our primary focus in the fight against AMR.
More research needs to be conducted in order to grasp the impact of how pharmaceutical products spread into the environment and lead to an increase in antimicrobial resistance. Prophylaxis antimicrobial treatment due to inaccurate diagnosis, as we have seen in cases of hospitalised COVID-19 patients, is another driver, leading to extensive use of antimicrobial medication.
Research needs to focus on developing accurate diagnosis kits to differentiate between viral and microorganism infections and to track the evolution of co-infections with bacteria. Conventional water and wastewater treatment processes are unable to adequately filter recalcitrant pharmaceuticals, so it is necessary to develop and scale up the use of new and advanced treatment technologies prior to discharging wastewater back into the environment.
“Now more than ever we need to commit to fighting the spread of this silent pandemic, driven by the rise of super-resistant bacteria”
However, there are limits to what prevention and containment can alone achieve in the fight against global health crises. This deadly virus has galvanised the entire planet, with countries competing against each other to be the first one to find a cure, a vaccine that can prevent further spreading of the virus.
Whereas for the COVID-19 pandemic there is a competition amongst companies and countries alike, the same thing cannot be said when it comes to finding new generations of antibiotics. Declining private investment and lack of innovation in the development of new antibiotics are undermining efforts to combat drug-resistant infections.
According to the WHO, we have fallen behind the curve and are now many years away from seeing innovative treatment on the market that can bring consistent improvements comparable to already available antibiotics and current standards of care.
Rushing to find a cure in the midst of a health crisis, as we are currently doing, is not a sound strategy, so we need to plan ahead and support funding for research and development of new and improved generations of antimicrobials. Antimicrobial resistance is like a snowball rolling down a hill - it starts small but can quickly grow to an unmanageable size.
Now more than ever we need to commit to fighting the spread of this silent pandemic, driven by the rise of super-resistant bacteria.