A GLOBAL EMERGENCY
AMR is recognized by institutions such as:
WHOWorld Health Organization, CDCCenters for Disease Control and Prevention, G20, UNITED NATIONS GENERAL ASSEMBLY, EUROPEAN COMMISSION
The global consumption of antibiotics is still increasing
Global consumption of antibiotics in human medicine rose by 36% between 2000 and 2010. (ref.57)Van Boeckel TP et al. Global antibiotic consumption 2000 to 2010: an analysis of national pharmaceutical sales data. The Lancet Infectious Diseases 2014;14:742-750. DOI:10.1016/S1473-3099(14)70780-7 This general figure masks declining use in some countries and rapid growth in others. The combination of limited health-care systems and rising incomes to spend on drugs makes emerging countries especially susceptible to overconsumption. Brazil, Russia, India, China and South Africa accounted for three quarters of the global increase in demand for antibiotics between 2000 and 2010, while annual per-person consumption of antibiotics varied by more than a factor of 10 across all middle and high-income countries. (ref.57)Van Boeckel TP et al. Global antibiotic consumption 2000 to 2010: an analysis of national pharmaceutical sales data. The Lancet Infectious Diseases 2014;14:742-750. DOI:10.1016/S1473-3099(14)70780-7
Increased mortality because of antibiotic resistance
In India, a child dies every nine minutes from an infection caused by antibiotic resistant bacteria. (ref.01)Antimicrobial resistance WHO Fact sheet N°194, updated April 2015.
(http://www.who.int/mediacentre/factsheets/fs194/en) In the European Union and the USA, some 48,000 people die every year because of antibiotic resistance. (ref.04)Antibiotic Resistance Threats in the United States. Centers for Disease Control and Prevention, 2013.
(http://www.cdc.gov/drugresistance/threat-report-2013/pdf/ar-threats-2013-508.pdf) (ref.05)Technical Report - The bacterial challenge: time to react
(https://ecdc.europa.eu/en/publications/Publications/0909_TER_The_Bacterial_Challenge_Time_to_React.pdf) In all probability, these are underestimates of the numbers of deaths because of the lack of consistent universal surveillance.
Increased morbidity because of antibiotic resistance
As well as causing increased mortality, infections by resistant bacteria are more difficult to treat and are more likely to complicate many aspects of a hospitalization.
The detection of antibiotic-resistant bacteria in the hospital environment or in a particular patient can lead to the increased need for isolation wards, cancellation or delay of treatments and surgery, as well as other costly and impactful consequences to the healthcare system. In fact, doctors increasingly worry that antibiotics, when used prior to a risky medical procedure to prevent infectious complications, may no longer function to prevent these infections. Under these circumstances, and faced with the current dearth of new antibiotics, they may have to avoid or reduce high-risk but life-saving medical procedures. When treating such antibiotic-resistant infections, clinicians may have limited therapy options – the use of more toxic options or combining multiple antibiotics, which can cause increased side effects.
The impact of antibiotic resistance on lives, health systems and economies is considerable and will continue to grow. Some estimates of the economic effects have been published, and the findings are disturbing. For example, the yearly cost to the US health system alone has been estimated at 21 to 34 billion dollars, as well as more than 8 million extra days in the hospital. (ref.07)Spellberg et al. Combating Antimicrobial Resistance:Policy Recommendations to Save Lives. Clinical Infectious Diseases 2011;52:397-428.
(http://cid.oxfordjournals.org/content/52/suppl_5/S397.full.pdf) In the EU, resistance to antibiotics costs an estimated €1.5 billion per year. (ref.08)Burden of Antibiotic Resistance. Action on Antibiotic Resistance (ReAct), 2012.
(http://www.reactgroup.org/uploads/publications/react-publications/ReAct-facts-burden-of-antibiotic-resistance-May-2012.pdf) Medical costs are only part of the economic equation: reduced employment and income, and increased national healthcare spending also have to be taken into account in assessing the financial impact. The EU estimates that resistance to antibiotics causes 600 million days of lost productivity each year, whereas in Thailand some researchers estimate that it leads to US$2 billion of productivity losses per year. (ref.09)Prakongsai et al. Prevention and Control of Antimicrobial Resistance in Thailand. Presentation at side event on antimicrobial resistance, 65th World Health Assembly, 2012. The O’Neill report estimates that by 2050, antibiotic resistance may lead to US$100 trillion in induced world GDP loss. (ref.10)Tackling drug-resistant infections globally: final report and recommendations.The Review on Antimicrobial Resistance chaired by Jim O’Neill. May 2016. - (https://amr-review.org/Publications.html)
According to the World Bank, without antibiotic resistance containment, the annual costs could become as massive as those of the global financial crisis that started in 2008. Moreover, the Sustainable Development Goals for 2030 – such as ending poverty, ending hunger, ensuring healthy lives, reducing inequality, and revitalizing global partnerships – are likely to remain unachieved. (ref.72)World Bank. 2016. “Drug-Resistant Infections: A Threat to Our Economic Future (Discussion Draft).” Washington, DC.