Around the world, the spread of dangerous infections that do not respond to antibiotics has been increasing by as much as 15% a year, affecting treatment for urinary tract infections, gonorrhea, E. coli and other pathogens that kill millions of people annually, according to a report released Monday by the World Health Organization.
The report documents how countries are grappling with the challenge of so-called antimicrobial resistance. It found that 1 in 6 infections in 2023 was resistant to the current roster of antibiotic drugs. The drug resistance involves 40% of the most common antibiotics used against these infections.
Southeast Asia and the eastern Mediterranean had the highest rates of resistance, with 1 in 3 infections resistant to antibiotics. That is roughly double the worldwide average and more three times the rates in Europe and the Western Pacific.
Overall, antimicrobial resistance was more prevalent in low- and middle-income countries, especially those with weak health care systems.
“Antibiotic resistance is widespread and threatening the future of modern medicine,” Dr. Yvan Hutin, director of the WHO’s department of antimicrobial resistance, said in a news conference announcing the surveillance results. “Simply put, the less people have access to quality care, the more they’re likely to suffer from drug-resistant infection.”
Drug-resistant bacterial and fungal infections kill more than 1 million people around the world each year and contribute to the deaths of nearly 5 million others, according to the health agency’s estimates. A study published in The Lancet estimated that more than 39 million people would die from antibiotic-resistant infections in the next 25 years.
In many ways, antimicrobial resistance, or AMR, is unavoidable. Over time, pathogens can evolve to outsmart the drugs created to kill them. Excessive use of antimicrobials, however, accelerates the process.
At the same time, the pipeline for new drugs has largely dried up, the result of a broken marketplace for antimicrobials that has driven the world’s biggest pharmaceutical companies from the field. Companies that have tried to make new antibiotics have been unable to make money from them.
“For many of these threats, the consequences are real — harder-to-treat infection, rising costs and lives lost,” Hutin said.
The report sounded the alarm on so-called gram-negative bacteria, which pose additional challenges because of a protective outer membrane that can be tough for antibiotics to penetrate. Gram-negative bacteria include Escherichia coli and Klebsiella pneumoniae, which are often implicated in severe infections that lead to sepsis and death. In Africa, resistance to cephalosporins, a class of antibiotics and the first choice treatment for such infections, can exceed 70%.
Without meaningful action, the effects of this death toll on the global economy could be staggering. A report published last year by the Center for Global Development estimated that drug-resistant infections could lead to a $1.7 trillion reduction in economic output by 2050, much of it driven by lost productivity or the early deaths of family breadwinners.
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