Explained: Antimicrobial Resistance And Its Impact On Public Health

Antimicrobial resistance (AMR) happens when microorganisms such as bacteria, fungi, viruses, and parasites develop the ability to continue to grow, even when they are exposed to antimicrobial agents that are meant to kill them or limit their growth.

As a result, these medicines become ineffective and the infection persist in the human body, increasing the risk of spread to others. Development of resistance happens when the microbes are frequently exposed to antimicrobial agents at suboptimal concentrations.

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Although AMR is a natural phenomenon, resistance develops more rapidly through the misuse and overuse of antimicrobial agents. Unnecessarily long or failure to complete an antibiotic course, self-administration without regulated prescriptions, inadequate surveillance plays a cardinal role in promoting AMR.

The use and abuse of anti-infectives in agriculture and animal husbandry, coupled with product quality management issues, are other prominent contributors to AMR. A recent global study estimates that if no concerted action is taken against AMR, it could result in 10 million deaths per annum and reduce the global GDP by 3% by 2050.

While AMR is often associated with hospital-acquired infections, a large chunk of disease burden can be attributed to drug-resistant tuberculosis and malaria. While otherwise completely curable infections, these drug-resistant infections have impacted the healthcare systems. Despite all the progress made in modern medicine, AMR can destabilise economies and can become the single largest factor impacting sustainable development goals (SDG¡¯s) for humanity at large.

The cost of AMR to national economies, food production, travel and health systems is significant. As the antibiotics become less effective, the risk of treatment failure increases, thereby compromising cancer chemotherapy and post-surgical management resulting in prolonged hospital stay and increase in treatment costs. This has a major influence on the patient and caretaker¡¯s productivity with an eventual decrease in the workforce and the quality of the country¡¯s human capital.

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Due to AMR, the gap between developing and developed countries becomes more pronounced. Underprivileged population from low-income countries will eventually be affected the most because these countries are more contingent on labor income, thereby directly impacting the gross domestic product (GDP).

Global trade is bound to be heavily affected with global exports predicted to decrease significantly by 2050 due to the widespread effects of AMR on labor-intensive economies. Impacts of AMR on multiple industries, primarily livestock output is also significant. The increase in resistance to antimicrobials makes treatments on livestock diseases ineffective, leading to decreased production and resulting in elevated prices of protein sources such as milk, egg, and meat.

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A global shortage of food in the form of protein source could have a direct impact on the nourishment status of poorer sections of the population. Therefore, the undesirable outcomes of AMR on the global economy are projected to be even more severe than the global financial recession.

The fight against AMR requires a holistic and integrated ¡°One-Health¡± approach involving the participation and commitment from multiple stakeholders across the veterinary, public health, and environmental sectors. We need to devise efficient strategies for creating global public awareness, improving sanitation and hygiene, ensuring responsible use of antibiotics guided by microbiological evidence. Building widespread antimicrobial surveillance systems that support strong antimicrobial stewardship and affordable and equitable access to high-quality antibiotics are imperative in this battle against AMR.

Funding and enabling the development of innovative, sensitive, point-of-care diagnostics would ensure ¡°prudent patient prescriptions¡± to guide the judicious use of antibiotics in the community and hospital settings. A problem of such global magnitude is slowly but continuously being addressed at multiple levels of the society to create long-term, sustainable solutions to tackle AMR.

About the author: Leela Maitreyi is the Director of Business Development at Bugworks Research India Pvt Ltd Bangalore. All views/opinions expressed in the article are of the author.