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COVID has been and gone. Global health concerns have shifted. Antimicrobial Resistance, also known as AMR, is now one of the top global health concerns. COVID showed us that infectious diseases know no borders and that global health affairs can rapidly spiral out of control.
So why isn’t AMR making global headlines in the same way COVID did?
Without the same immediacy and spectacle as COVID, yet with similar devastating consequences, AMR is still an under-prioritised issue. It is an ongoing, urgent problem, but its multifaceted nature makes it difficult to solve. It is not only a global health problem, but one of agriculture, politics and economics.
The World Health Organisation (WHO) found in a recent study that one in six bacterial infections affecting the population were resistant to antibiotics. Alongside this, antimicrobial resistance as of 2019 was responsible for 1.27 million global deaths and contributed to a further 4.95 million deaths. Antimicrobial resistance is a slower-moving crisis than COVID, but the same urgency is needed.
Since Alexander Fleming discovered Penicillin 100 years ago, antibiotics have been fundamental to modern medicine, but while diseases evolve and develop, the world of medicine must too.
But what can be done?
Although AMR seems like it is predominantly a medical crisis, its implications extend far beyond health, posing significant economic and political threats across borders.
The World Bank estimates that AMR could result in US$1 trillion additional healthcare costs by 2050. Infections that have been treatable since the discovery of penicillin now require added treatment, longer hospital visits and more expensive drugs. For lower-income countries, where the required equipment, space and expertise are not available, their healthcare systems and economies are strained. Estimates show that AMR is presenting the most burdens to countries in Sub-Saharan Africa and South Asia, where medical development does not have the same funding as higher-income countries.
Due to the uncertainty surrounding the trials and testing of new, alternative antibiotics, there is a lack of funding. There is little to no economic incentive for big pharmaceutical companies like Pfizer and AstraZeneca; therefore, the development of alternatives is stunted.
Alongside the economic nuances of the problem, there is still a political issue too. AMR is a transboundary problem across countries. Yet no policy solution is ‘one size fits all’. Although AMR poses a global threat, countries vary in their capacities and priorities for addressing it. At a domestic level, countries will respond differently.
As well as AMR being a transboundary problem, the nature of it is too dependent on the cooperation of sovereign states. In these states, AMR is not high up on the agenda. For example, in the UK, the news is crowded with stories of immigration and the cost-of-living crisis. These domestic issues are higher on the agenda than AMR, because they are short-term. AMR is a problem that will build gradually, but with catastrophic consequences. If sovereign states prioritise domestic concerns over global collaboration, progress towards eliminating AMR will be slow and ineffective.
The AMR crisis is not merely at our doorstep; it has entered the house.
The economic and political nuances of the problem make it a complex crisis to solve. A change in belief is needed; when the economic repercussions become clearer, a higher political priority will follow. With this, powerful countries may collaborate at an international level, whereby real progress can be made. The WHO have already set out a Global Action Plan, in which 5 objectives towards an AMR-free future are proposed. But for this Global Action Plan to be effectively implemented, there needs to be economic incentives for pharmaceutical investment and a shift in attitude from higher-income countries to support those most affected.
COVID has been and gone, but AMR is here to stay.
Image: Antibiotic Resistance by Nick Youngson // CC BY-SA 3.0
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