In today’s Finshots, we explore why antimicrobial resistance is becoming a serious threat and what’s been done to stop it.

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The Story

If you get a small cut while chopping vegetables, you’d normally slap on a band-aid, and you’re good to go. But what if that minor cut gets infected and no antibiotic could help? That’s the reality we’re inching towards, all thanks to something called antimicrobial resistance, or AMR. ¹

AMR is when bacteria and parasites evolve to outsmart the drugs and medicines we use to kill them. That means antibiotics stop working. And this could have devastating consequences.

According to some experts, by 2050, AMR could lead to 39 million deaths globally, including 2 million in India alone.²

Worse, global healthcare costs could surge by $159 billion annually.

And over 1.2 million people died in 2019 from infections that couldn’t be treated with existing drugs. Essentially, we’re inching towards a world where antibiotics, the very drugs that have saved millions of lives, might stop working altogether.

But to understand how we got here, let’s rewind a bit.

See, antibiotics were once seen as miracle drugs. Discovered by accident in 1928 by scientist Alexander Fleming, the mould-based antibiotic, penicillin, changed medicine forever. Infections that were once death sentences were suddenly curable with a few pills. Surgeries became safer, organ transplants possible, and modern medicine thrived.

But over time, we got a little too comfortable.

Doctors started prescribing antibiotics for everything, even viral infections that antibiotics can’t treat.

Then in the 1950s, animal farming became more industrialised and farmers began adding antibiotics to animal feed to prevent infections and help them grow faster. This was seen as a win for productivity, but it came at a heavy price. Because over time, bacteria in animals evolved to become resistant to these drugs. And those same drug-resistant bacteria can jump to humans, potentially threatening both animal and human health.

Today, we have superbugs - the bacteria that no longer respond to the usual antibiotics. The problem is particularly severe in countries like India, where antibiotics are over-prescribed and easily available without a prescription. Pharmacies often sell antibiotics over the counter, and doctors sometimes overuse them due to incentives from pharma companies.

Hence, today, we’ve reached a point where even the strongest antibiotics are starting to fail.

The problem is especially acute in LMICs (low and middle-income countries). Hospitals, which should be places of healing, have become breeding grounds for the most stubborn, drug-resistant infections. Around 11% of patients in these regions develop infections after surgery, a direct consequence of AMR.³ And in places where healthcare systems are underfunded, drug-resistant infections like sepsis spread rapidly, often with devastating consequences.

Take Nigeria, where doctors tried every standard antibiotic to treat a newborn suffering from sepsis, a life-threatening infection. Nothing worked. They had to rely on meropenem, one of the most powerful antibiotics, but even that wasn’t guaranteed to work.

And it’s not just Nigeria. In war-torn areas like Ukraine, Gaza, and Sudan, AMR is making already dire situations worse. Imagine getting wounded in battle and not having the right antibiotics to treat the infection. In Gaza alone, antibiotic resistance has surged by 300% in recent years. And when people flee these zones, they also unknowingly carry drug-resistant bacteria with them, spreading AMR far and wide.

So why aren’t we developing new antibiotics faster if the problem is so severe?

The issue is simple: money. Developing new antibiotics can take 10 to 15 years and costs over a billion dollars.

New antibiotics are also seen as the "last line of defense" against deadly bacteria as doctors use them sparingly to prevent resistance from building up. Plus, antibiotics are generally sold at lower prices. So, when you combine low sales volumes with low prices, the profit margins shrink. This has led many big pharma companies to exit the antibiotics market altogether.

But it’s not all doom and gloom.

Some pharmaceutical companies and governments are stepping up to fight AMR.

In India, Wockhardt is preparing to launch Zaynich (WCK 5222) by 2025 to fight multi-drug resistant (MDR) and extensively drug-resistant (XDR) pathogens.⁴

Globally, companies like GSK, Pfizer, and Merck are working on new antibiotics, with Basilea Pharmaceutica developing treatments to combat the cause of hospital-acquired infections.

There are also global initiatives like the AMR Action Fund aiming to bring 2-4 new antibiotics to market by 2030. And the U.S. Department of Health and Human Services (HHS) is funding the TARGET Project, which uses artificial intelligence (AI) to accelerate the discovery of new antibiotics.⁵

But here’s the thing.

While developing new antibiotics is crucial, the real challenge lies in making antibiotic development sustainable. And if we don’t get this right, AMR could very well take us back to the pre-antibiotic era, where even the smallest infection could be life-threatening.

So, what’s the solution, you ask?

Well, no single country can tackle AMR alone. It’s a global problem, and it needs a global solution.

We need countries, industries, and health systems to come together.

Tighter regulations on antibiotic use, bigger investments in drug research, and raising awareness about the dangers of overusing antibiotics are the only ways to stop AMR in its tracks.

And the time to act is now.

Until then…

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Story sources: DownToEarth [1]; ncbi.nlm.nih.gov [2], The Hindu [3]; Business Standard [4]; U.S. Deparment of Health and Human Services [5]

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