By: ABRS- Academic Team

Introduction

Antimicrobial resistance (AMR) is one of the most critical global health issues of the 21st century. This phenomenon occurs when bacteria, viruses, fungi, and parasites develop resistance to medications, threatening to reverse decades of medical advances. Recent estimates indicate that AMR already causes over one million deaths annually, a figure expected to rise dramatically without urgent action. This document explores both the future projections of AMR and the strategies that must be adopted to mitigate its global impact.

Current and Future Impact of Antimicrobial Resistance

AMR is projected to become one of the leading causes of death globally. In 2021, an estimated 1.14 million deaths were directly attributed to infections resistant to antimicrobials, a figure expected to increase by 67.5% by 2050, reaching 1.91 million annual deaths. However, AMR will not only be a direct cause of deaths; it is also anticipated to contribute to a much larger figure, with 8.22 million global deaths linked indirectly to resistant infections by mid-century.
From 2025 to 2050, it is estimated that more than 39 million deaths will be directly caused by AMR, with a broader influence on approximately 169 million deaths. Deaths among children under five will continue to decline, but this trend will be overshadowed by increases in other age groups, particularly among individuals over 70, where a projected increase of 146% is expected. These trends highlight significant global disparities, with a disproportionate rise in regions like North Africa and the Middle East compared to high-income countries.
The future impact of AMR will be most severe in South Asia, covering countries such as India, Pakistan, and Bangladesh, where 11.8 million direct deaths due to AMR are projected between 2025 and 2050. Other regions, such as sub-Saharan Africa and East Asia, will also see alarming figures.

Future Projections: The Worst Scenario Can Still Be Avoided

Despite the grim projections, the worst-case scenario can be averted through immediate and coordinated action. According to models, improving access to antibiotics and infection care could prevent up to 92 million deaths between 2025 and 2050, especially in regions like South Asia, sub-Saharan Africa, and Southeast Asia. Developing new antibiotics targeting Gram-negative bacteria could also avert 11.08 million deaths attributable to AMR globally during the same period.
Solutions include not only the creation of new medications but also implementing better prevention strategies, such as developing vaccines, improving access to existing antibiotics, and providing proper guidance for their use. Dr. Stein Emil Vollset from the Norwegian Institute of Public Health emphasizes the importance of these interventions in preventing AMR from escalating into a major crisis. Coordinating global actions and addressing limitations in data collection, particularly in low- and middle-income countries where information on antimicrobial resistance is insufficient, is crucial.

Immediate Priorities for a Comprehensive Global Approach

The fight against AMR cannot wait, and immediate priorities must be addressed with urgency. Countries like Australia are already taking steps in this direction by establishing a ‘One Health’ approach that connects human, animal, and environmental health. This model can be replicated by other nations as it promotes collaboration and coordination among the different sectors involved.
One of the first steps is to review governance structures to ensure effective decision-making aligned with ‘One Health’ principles. Establishing sector-specific action plans for each area of health is essential to ensure that efforts are well-coordinated and overseen. Additionally, a monitoring and evaluation framework must be developed to measure progress at local, regional, and national levels.
Raising public awareness about antimicrobial resistance is also a key component. Educational campaigns should be better coordinated and targeted at diverse audiences, including integrating these topics into school curricula. Moreover, fostering greater public involvement by educating individuals on the responsible use of antimicrobials is vital.
Lastly, developing a coordinated national research agenda is crucial to avoid duplication of efforts and ensure funding is directed to critical areas. Research on AMR should be prioritized and coordinated to identify gaps and direct resources where they are most needed, such as improving rapid diagnostics that allow timely treatment.

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