A new report suggests that over 750,000 deaths from antimicrobial resistance (AMR) could be prevented annually through existing infection control measures.
Published in The Lancet, the modelling analysis found that a quarter of a million AMR deaths could be avoided in Low- and Middle-income Countries (LMICs) by improving and expanding infection control methods.
These measures include improving hand hygiene, regularly cleaning and sterilising healthcare facility equipment, increasing access to clean drinking water, effective sanitation, and implementing paediatric vaccines.
Researchers believe improved infection control will be key to reducing deaths from AMR and protecting vulnerable populations.
Global burden of AMR
Annually, there is an estimated 7.7 million deaths worldwide caused by bacterial infections – around 1 in 8 of all global deaths.
This makes bacteria infections the second largest cause of death globally. Of these deaths, around five million are associated with antibiotic-resistant bacteria.
This resistance poses a significant challenge for the medical sector in developing effective treatments for these conditions.
Professor Iruka Okeke of the University of Ibadan explained: “Access to effective antibiotics is essential to patients worldwide.
“A failure to provide these antibiotics puts us at risk for not meeting the UN sustainable development goals on child survival and health ageing.
“Effective antibiotics prolong lives, reduce disabilities, limit healthcare costs and enable other life-saving medical actions such as surgery.
“However, antimicrobial resistance is on the rise – accelerated by inappropriate use of antibiotics during the COVID-19 pandemic – threatening the backbone of modern medicine and already leading to deaths and disease which would have once been prevented.”
Vulnerable populations
Antimicrobial resistance poses a significant threat to newborn survival worldwide.
Infections are responsible for a third of neonatal deaths globally, with half of these deaths attributed to sepsis, a severe and potentially fatal systemic response to infection.
The situation is exacerbated by the fact that the bacteria and fungi causing these infections are increasingly resistant to commonly available antibiotics.
For instance, a study conducted between 2018 and 2020 across 11 countries in Africa, Asia, Europe, and Latin America found that 18% of newborns with sepsis did not survive despite receiving antibiotic treatment.
AMR also presents a considerable risk to the elderly and those with chronic illnesses, particularly when they require medical care in hospitals and long-term care facilities.
It compromises the efficacy of routine medical procedures such as organ transplants, joint replacements, cancer chemotherapy, and the management of non-communicable diseases like cardiovascular disease, diabetes, and chronic respiratory conditions.
Infection control methods to reduce AMR deaths
The modelling analysis found that existing infection control measures could prevent 750,000 AMR deaths each year.
Enhancing infection prevention and control measures in healthcare facilities, including improved hand hygiene and more frequent cleaning and sterilisation of equipment, has the potential to save up to 337,000 lives annually.
Additionally, ensuring universal access to safe drinking water and effective sanitation in community settings could prevent approximately 247,800 deaths from AMR each year.
Moreover, expanding the distribution of certain paediatric vaccines, such as pneumococcal vaccines that protect against pneumonia and meningitis, and introducing new vaccines like RSV vaccines for pregnant mothers could result in saving 181,500 lives annually.
Professor Joseph Lewnard of the University of California in Berkeley added: “Focusing on interventions with demonstrated effectiveness in preventing infections must be at the heart of global action to tackle AMR.
“Preventing infections reduces the use of antibiotics and reduces selection pressure for AMR so that the drugs will work when they are most needed.”
Improving antibiotic development
They explained that the rise in bacterial infections resistant to all available antibiotics highlights the urgent need for global investment in new antibiotics, vaccines, and diagnostic tests.
The traditional profit-driven drug development model is failing for antibiotics, as most new antibiotics are not registered in LMICs and remain unaffordable even when they are.
The authors advocate for new, publicly funded antibiotic development models based on public-private partnerships to increase the availability of novel treatments and reduce patients’ out-of-pocket costs, enhancing accessibility.
Additionally, they call for greater funding for AMR prevention programmes, noting that current funding for AMR is significantly lower than for diseases with smaller burdens like HIV, malaria, and TB.
2030 AMR targets
AMR will be a focal point during the upcoming United Nations General Assembly in September 2024, where it will be addressed for the second time at a High-Level Meeting.
The study outlines ambitious but attainable global targets for 2030, which should be adopted within a framework of universal access to antibiotics.
These ’10-20-30 by 2030′ goals include:
- A 10% reduction in AMR-related mortality through scaled-up public health interventions to prevent infections, thereby reducing antibiotic use and resistance
- A 20% reduction in inappropriate human antibiotic use by limiting antibiotics for mild respiratory infections that typically do not require them
- A 30% reduction in inappropriate antibiotic use in animals achieved through various sector-specific actions. Policy examples to support these goals include prohibiting the use of medically important antimicrobials for growth promotion in animals, banning the highest-priority critically important antimicrobials for preventive treatment in animals, and ensuring all antibiotics are administered under veterinary guidance
The researchers are also calling on the establishment of an independent scientific body for antimicrobial resistance to expand the evidence base for policy implementation and inform new targets.
