Editorial: Health crisis looms large

Even as nations are grappling with the devastating impact of the coronavirus pandemic, another public health crisis is looming large over the world: bacterial infections that are resistant to existing antibiotic drugs. Antimicrobial resistance (AMR) is the new threat to public health that warrants urgent global action to save lives. Hundreds of thousands of deaths […]

Even as nations are grappling with the devastating impact of the coronavirus pandemic, another public health crisis is looming large over the world: bacterial infections that are resistant to existing antibiotic drugs. Antimicrobial resistance (AMR) is the new threat to public health that warrants urgent global action to save lives. Hundreds of thousands of deaths are occurring today due to previously treatable infections — such as lower respiratory and bloodstream infections — because the bacteria that cause them have become resistant to treatment. More than 1.27 million people died in 2019 alone as a direct result of antibiotic-resistant bacterial infections. AMR is killing more people than HIV/Aids or malaria, according to a comprehensive global study published in the medical research journal ‘Lancet’. Like Covid-19, AMR too needs global collaboration with public and private sectors and healthcare communities working together to tackle the threat to public health. The latest report — Global Research on Antimicrobial Resistance (Gram) — estimates deaths linked to 23 pathogens and 88 pathogen-drug combinations across 204 countries and territories. Another study by the Indian Council of Medical Research (ICMR) from 10 hospitals showed that when Covid-19 patients acquire drug-resistant infections in hospitals, the mortality is almost 50-60%. While AMR poses a threat to people of all ages, young children were found to be at particularly high risk, with one in five deaths attributable to resistance to antibiotics occurring in children under the age of five.

This is the first time we have evidence-based numbers as to what could be the toll of drug resistance in terms of mortality. Previous estimates of the health impact of AMR have been published for several countries and regions, and for a small number of pathogen-drug combinations in a wider range of locations. However, until now, no estimates have covered all locations or a broad range of pathogens and drug combinations. Now, there is a need to leverage this data to undertake course correction and drive innovation if we want to stay ahead in the race against antimicrobial resistance. The new health crisis also highlights the urgent need to formulate global action plans to save lives and protect health systems. These must include optimising the use of existing antibiotics, taking greater action to monitor and control infections, and providing more funding to develop new antibiotics and treatments. The indiscriminate use of antibiotic drugs must be discouraged as it can play havoc with the immune system. There is a lot of improper use of antibiotics happening in the treatment of Covid patients too. For instance, Azithromycin was routinely prescribed for all Covid patients during the initial stages of the pandemic even though there is no evidence of its benefit. The lack of regard for the life-saving value of antibiotics will have an adverse impact on public health in the long run.

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