Bacterial infections resistant to available antibiotic medicines will cause more than 39 million deaths worldwide over the next 25 years and indirectly contribute to an additional 169 million deaths, according to a forecast published on Monday. FRANCE 24's Sharon Gaffney speaks to Ben Cooper, Professor of Epidemiology at the Centre for Global Health Research at Oxford University and one of the authors of the report. He says that vaccines, hygiene and antibiotic education are key to avoiding this crisis.
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00:00To apropos. Superbugs that are resistant to antibiotics will kill more than 39 million
00:09people worldwide over the next 25 years. That's according to a new study published in The
00:14Lancet. Antimicrobial resistance occurs when pathogens develop the ability to evade the
00:20medications used to kill them and infections that were once easy to cure with antibiotics
00:26become untreatable. Jean-Emile Jamin has the details.
00:33Antibiotic resistance, a problem reaching crisis levels. According to a recent study
00:38published in The Lancet, over 39 million people could die from drug-resistant infections in
00:43the next 25 years if urgent action isn't taken. And it's not just direct deaths. The study
00:49warns of an additional 169 million lives lost indirectly due to complications associated
00:55with antibiotic resistance. For perspective, by 2050, researchers say deaths associated
01:00with antibiotic resistance could increase by up to 75% from what we're seeing today.
01:06The study also highlights how low- and middle-income countries are said to bear the brunt of the
01:11crisis, especially in sub-Saharan Africa and South Asia. These regions already experience
01:16the highest rates of antibiotic-resistant related deaths, driven primarily by infections
01:21like multi-drug-resistant tuberculosis. The elderly are also most at risk from antimicrobials,
01:27with deaths up by 80% in the past three decades amongst over-70s. And the economic impact
01:33is equally concerning. Researchers predict that by 2030, the global
01:37economy could suffer losses of up to $3.4 trillion annually. The ripple effects of this
01:42burden could strain healthcare systems and hurt national economies, particularly in countries
01:47that can least afford it. The report suggests that measures like improving
01:51care for serious infections, developing new vaccines and promoting judicious use of antibiotics
01:57could save up to 92 million lives between now and 2050. These findings come just days
02:02ahead of a UN General Assembly meeting on the issue, highlighting the urgent need for
02:07global cooperation.
02:08For more, we're joined now by Professor Ben Cooper from the Centre for Global Health Research
02:14at Oxford University. He's also one of the authors of the report. Thank you so much for
02:19being with us on the programme this evening, Professor. So firstly, what has gone so wrong
02:25with how these drugs are being prescribed and used?
02:30That's a good question. I think over a number of years, we got used to having lots of new
02:38antibiotics being developed all the time. And what's happened in the last 20 years is
02:45that pipeline of new antibiotics has really slowed down. So now it's really just a trickle
02:51of new antibiotics coming through. And at the same time, the bugs have been evolving
02:56resistance to the antibiotics that we already have. And in many parts of the world, the
03:02way we use antibiotics is actually very careless. There's lots of unnecessary use of antibiotics
03:08for treating viral infections where they're not effective at all, or using them in animal
03:14production. And all these actually make a contribution to the problem.
03:20According to the report, by 2050, not far off 2 million people will be dying from illnesses
03:26attributed directly to antibiotic resistance each year if remediation measures aren't put
03:32in place. So what exactly needs to be done?
03:37So I think there are really three things that we can do. The first thing is that we can
03:43expand on measures to prevent bacterial infections. And we have seen some positives. So our study
03:50found that actually in the under five-year-olds, there was a reduction in deaths due to antimicrobial
03:56resistance. And that reduction occurred because we are able to stop infections by using vaccines
04:03and using better hygiene. So we really need to think very carefully about how we can increase
04:09the use of vaccines to prevent infections and also increase hygiene measures to prevent
04:14those infections spreading, both in hospitals and in community populations. So that's one
04:21thing. The second thing we can do is be much smarter about the way we use antibiotics.
04:28So we can develop and use more rapid tests to actually determine very quickly whether
04:34bacteria causing infections can be treated with different antibiotics and we can target
04:40them appropriately. And we can also reduce the inappropriate use of antibiotics. And
04:47there are specific targets that many countries are aiming to achieve in this. And the third
04:56thing that we can do is really invest in the development of new antibiotics. And the
05:03difficulty there is that these are not a profitable product for pharmaceutical companies. So really
05:14in the last 20 years, we've seen pharmaceutical companies not investing in this area. So we
05:20need to make incentives. So it makes it worth the while of pharmaceutical companies to actually
05:25invest in developing new drugs.
05:29Professor, we often see doctors, as you say, being blamed for over-prescribing antibiotics,
05:34patients for demanding them. But some experts say there's also another factor at play and
05:39that's the manufacturing process where pharmaceutical companies, they often dump antibiotics into
05:45wastewater. So what can be done to guard against that practice? You've also mentioned it yourself
05:50earlier then as well, antibiotics also being used to illegally promote animal growth.
05:55Yeah. It's certainly an issue that some factories are dumping antibiotics into wastewater. There's
06:06also runoff from agricultural use of antibiotics. And certainly these are areas where better
06:13regulation and better enforcement of regulation is needed. There's also a problem with actually
06:20companies making fake or substandard antibiotics, which still have some active ingredients, which
06:26can also promote resistance. So there's also a sort of really illegal element of this, which
06:33may be making a contribution to the problem as well.
06:37And global leaders are due to meet at the UN General Assembly in New York later this month
06:42to discuss this very issue. Are you hopeful that there may be some progress made there?
06:47What exactly should governments be doing in the short term?
06:50I am hopeful. There've been a lot of positive signs and most countries now have national
06:58action plans to do something about the problem. And I think there is in a number of countries,
07:05a real political will to do something. So I'm optimistic that decisions will be made to take
07:13real action for this. I guess what we'd really like to see is to make sure that the investment,
07:18which is really needed to tackle the problem, goes along with that.
07:22And Professor, in a worst case scenario, I suppose, are we headed, as some experts would
07:28warn, for a so-called post-antibiotic era in which common infections, minor injuries
07:34that have been treatable for decades can no longer be cured and can once again kill patients?
07:42I think this is a real risk. And I would say also that that's already happening in some countries.
07:48So there are some countries where the last resort antibiotics that could potentially treat
07:53these resistant infections are not available or not affordable to patients. So right now,
08:00patients are dying because they have effectively untreatable infections. So we're seeing that less
08:06frequently in high-income countries. But that's certainly a risk that that could happen, yeah.
08:11And which parts of the world then are worst affected? There are reports that tens of
08:15thousands of newborn babies are dying each year in India because of antibiotic-resistant
08:21infections there. So as you say, this is something that's happening right now,
08:25and we're not just talking about something that's possibly going to be happening in 25 years' time.
08:31Yeah, that's absolutely right. I mean, the worst affected countries are certainly the
08:36lower-income countries. And the problem there is compounded. It's not just about resistance.
08:42It's also about lack of access to effective antibiotics. So kind of essential medicines
08:46are often not available in hospitals there as well. So those countries that also have the
08:52highest infection rates and compounded by the lack of effective drugs and drug resistance kind of
09:00makes a perfect storm really, yeah. So that's clearly where the largest problem is. And this
09:04is also where the problem is predicted to grow the most in the next 25 years or so.
09:11And in terms of just on an individual level, you know, patients going to the doctor and they
09:16might be demanding an antibiotic to treat various ailments that they believe that they have to,
09:21do people need to be better educated when it comes to antibiotics and also about how
09:26these drugs should be disposed of safely? I think there's certainly a role of education
09:34in, and we know that there certainly are problems where doctors feel under pressure to prescribe
09:40antibiotics where they're not really needed. So certainly sort of national education campaigns
09:45can play an important role in this. And just finally, Professor, who's the most at risk here?
09:50Are we speaking obviously of vulnerable people, but really it's older generations who are most
09:55at risk when it comes to this? That's absolutely right. And that's one thing that the report
10:00highlighted that the biggest increase in risk has been in the over 70s and a large part of the
10:08forecast increase, if appropriate measures aren't taken, is due to sort of demographic changes and
10:15the ageing population. So as we see more people in that over 70 age bracket, that's where the real
10:24greatest risk is. Okay, Professor, thank you so much for joining us. That is Ben Cooper from the
10:30Centre for Global Health Research at Oxford University. We do really appreciate your time
10:35on the programme this evening, one of the authors of that report in The Lancet. Thank you very much.
10:40That is it from us for now. Do stay with us though. Up next, it's Eye on Africa.