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Strong words must be translated into action, say experts, after a UN report warned that drug-resistant diseases could cause 10 million deaths a year by 2050 if nothing is done to tackle the spread of antimicrobial resistance (AMR).
 
Without a coordinated effort to address the problem, drug-resistant diseases could force up to 24 million people into extreme poverty by 2030 and cause as much damage to the global economy as the 2008 global financial crisis, the report by the UN Interagency Coordinating Group (IACG) on Antimicrobial Resistance said.

AMR occurs when bacteria mutate or change in ways that cut the effectiveness of a drug, allowing them to survive and multiply.

Diseases resistant to existing medicines already claim the lives of at least 700,000 people a year, including 230,000 people who die from multidrug-resistant tuberculosis, according to the landmark report published this week.

“This report reflects the depth and scope of the response needed to curb [AMR's] rise and protect a century of progress in health,”

Amina Mohammed, UN deputy secretary-general, IACG co-chair

It says common diseases have become untreatable and lifesaving medical procedures riskier to perform owing to “alarming levels of resistance”.

Amina Mohammed, UN deputy secretary-general and co-chair of the IACG, said antimicrobial resistance (AMR) was one of the greatest threats facing the global community.

“This report reflects the depth and scope of the response needed to curb its rise and protect a century of progress in health,” she said, adding: “I urge all stakeholders to act on its recommendations and work urgently to protect our people and planet and secure a sustainable future for all.”

Misuse and overuse of existing antimicrobials in humans, animals and plants are among the drivers of rapidly accelerating AMR, the report states.

It also highlights inadequate water and sanitation facilities, inequitable access to affordable medicines, and poor food safety and waste management as factors.

The problem is “complex and multifaceted” but “not insurmountable”, according to the IACG, whose recommendations include the creation of a global independent panel on AMR, akin to the UN’s Intergovernmental Panel on Climate Change (IPCC).

The report calls for a phasing out of growth-promoting antimicrobials in agriculture, with an immediate ban on using antibiotics of “critical importance” to humans on animals.

Greater public and private investment is also required, the group says, to spur innovation in antimicrobial medicines, diagnostics, and vaccines.

Jeremy Knox, AMR policy lead at UK-based research foundation the Wellcome Trust, said he was pleased with the recommendations, but they were “only a starting point”.

“More needs to be done to support the implementation of national action plans, particularly in low- and middle-income countries,” he said.

“We need to see a stronger offering from the WHO, FAO (Food and Agriculture Organization), OIE (World Organisation for Animal Health) in helping countries develop their plans.”

He also highlighted an urgent need to address the challenges facing antibiotic development, citing the recent bankruptcy of US biotech company Achaogen.

Developing new antimicrobial drugs is costly for pharmaceutical companies and offers poor returns due to the need to minimize their use.

“The effort and expense of getting a foothold in the market crippled them [Achaogen],” he said. “I think that is a real signal that the market for antibiotics does not work and we will see companies unable to make a return on their investments.”

Professor Eric Fèvre, professor of veterinary infectious diseases at the University of Liverpool, in Britain, said more data was needed to determine the true scale of the AMR crisis. “Much work needs to be done to understand antibiotic resistance risk factors, prevalence, geographical spread and burden attributable in humans and animals,” he told SciDev.Net.

Some countries are already on the right track, said Fèvre, citing Kenya as an example where “there is a national policy, a national action plan and funding is available to implement these plans”.

“Countries need to collect their own good data, undertake their own good surveillance and use this to support their own policymaking and actions for intervention,” he added.

This piece was produced by SciDev.Net’s Global edition.

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