Need for Action Antibiotic Resistance Predicted to Cause 39 Million Deaths by 2050

Antimicrobial resistance (AMR) threatens to cause over 39 million deaths by 2050, as revealed by a global analysis. Without urgent action, this looming crisis could reshape the future of global health.

A recent article published in The Lancet presents a first-of-its-kind global analysis of antimicrobial resistance (AMR) over time, emphasizing the significant threat AMR poses to global health. The study, conducted by the Global Research on Antimicrobial Resistance (GRAM) Project, examines trends in AMR from 1990 to 2021 and projects the health impacts through 2050 for 204 countries and territories. According to the analysis, more than 39 million deaths worldwide could result from AMR between now and 2050, and the annual death toll from AMR is projected to rise by nearly 70 % by 2050 compared to 2022 levels.

Between 1990 and 2021, AMR was responsible for over one million deaths annually, with AMR-associated deaths decreasing among children under five years old but significantly increasing among those aged 70 and older. The article highlights that while AMR-related deaths among young children have declined by 50 %, deaths among older adults rose by more than 80 %. This trend is expected to continue, with the elderly population facing a heightened risk as global populations age.

The GRAM study estimates that by 2050, AMR will lead directly to 1.91 million deaths annually and contribute to an additional 8.22 million deaths. The cumulative death toll from AMR is predicted to exceed 39 million between 2025 and 2050, with a broader impact on an estimated 169 million people. The highest burden of AMR-related deaths is expected in South Asia, sub-Saharan Africa, and other parts of southern and eastern Asia.

The authors stress the urgent need for global interventions to combat AMR, including improved access to healthcare, the development of new antibiotics, vaccination efforts, and more stringent controls on antibiotic use. The study suggests that 92 million deaths could be prevented if access to healthcare and antibiotics improves in regions where AMR is particularly rampant. Furthermore, investing in research to develop new drugs targeting Gram-negative bacteria could save over 11 million lives by 2050.

The article underscores the growing danger posed by antibiotic-resistant pathogens, especially those resistant to drugs like carbapenems, which are critical to treating life-threatening infections. Deaths due to methicillin-resistant Staphylococcus aureus (MRSA) have more than doubled since 1990, and resistance to Gram-negative bacteria, particularly carbapenem-resistant strains, has seen significant growth, further complicating treatment efforts.

The researchers relied on over 520 million individual records from a variety of sources, including hospital data, death records, and antibiotic use statistics, to develop statistical models that provided both retrospective and forward-looking estimates of AMR’s impact. These estimates account for direct AMR deaths, in which infections caused by drug-resistant pathogens were the primary cause of death, as well as deaths where AMR played a contributory role.

The findings highlight the need for robust infection prevention strategies, widespread vaccination programs, and a coordinated global effort to limit the inappropriate use of antibiotics. The study acknowledges some limitations, including a lack of comprehensive AMR data from certain low- and middle-income countries (LMICs) before 2000. This points to a crucial need for investment in infrastructure to improve data collection and enhance the accuracy of future forecasts.

Study authors, including Dr. Mohsen Naghavi of the Institute of Health Metrics (IHME) at the University of Washington, emphasize that AMR has been a critical global health threat for decades, and the situation is only worsening. Projections indicate that without significant changes, AMR will surpass current global health challenges like HIV/AIDS and malaria in terms of mortality. The article also includes a comment from Professor Samuel Kariuki, who highlights the importance of using these data to drive investments and targeted interventions to address AMR worldwide.

The study provides an urgent call to action for global health leaders, governments, and the medical community to take decisive steps to mitigate the looming threat of AMR. If left unchecked, resistant infections are expected to cause millions of deaths annually, disproportionately affecting older adults and vulnerable populations in LMICs. Progress is possible, especially through strategic interventions that prioritize access to healthcare, antibiotic stewardship, and the development of new treatments.

Original Article: Global burden of bacterial antimicrobial resistance 1990–2021: a systematic analysis with forecasts to 2050; The Lancet; DOI:10.1016/S0140-6736(24)01867-1

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