Superbugs: A looming global health catastrophe?

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  Quantumrun Foresight
• February 14, 2022

Insight summary

The threat of microorganisms developing a resistance to antimicrobial drugs, particularly antibiotics, is a growing public health concern. Antibiotic resistance, leading to the rise of superbugs, has created a global health security risk, with the United Nations warning that antimicrobial resistance could cause 10 million deaths by 2050.

Superbug context

Over the past two centuries, modern medicine has assisted in the eradication of numerous illnesses which were previously a threat to humans worldwide. Throughout the twentieth century, in particular, powerful drugs and treatments were developed which enabled people to live healthier and longer lives. Unfortunately, many pathogens have evolved and become resistant to these drugs. 

Antimicrobial resistance has resulted in an impending global health disaster and occurs when microbes, such as bacteria, fungi, viruses, and parasites, mutate to counteract the effects of antimicrobial drugs. When this happens, antimicrobial drugs are rendered ineffective and often necessitate the use of stronger classes of drugs. 

Drug-resistant bacteria, often known as "superbugs," have emerged as a result of factors such as antibiotic misuse in medicine and agriculture, industrial pollution, ineffective infection control, and a lack of access to clean water and sanitation. Resistance develops through multigenerational genetic adaptation and mutations in pathogens, some of which occur spontaneously, as well as genetic information transmission across strains.

 

Superbugs may often obstruct efforts to effectively treat common ailments and have caused several hospital-based outbreaks in recent years. According to the US Centers for Disease Control and Prevention (CDC), these strains infect over 2.8 million people and kill more than 35,000 people in the United States each year. These strains have increasingly been found circulating in communities, posing a serious health risk. Combating antimicrobial resistance is important since the problem has the potential to spiral out of control, with the AMR Action Fund projecting that mortality from antibiotic-resistant infections may increase to about 10 million per year by 2050.

Disruptive impact

Despite the emerging global threat of superbugs, antibiotics are still widely utilized, not only for the treatment of human infections but also in the agricultural industry. An increasing body of data, however, shows that hospital-based programs dedicated to managing antibiotic usage, commonly known as “Antibiotic Stewardship Programs,” can optimize the treatment of infections and minimize the adverse events associated with antibiotic use. These programs assist doctors to improve the quality of patient care and patient safety by increasing infection cure rates, reducing treatment failures, and increasing the frequency of the proper prescription for therapy and prophylaxis. 

The World Health Organization has also advocated for a strong, united strategy centered on prevention and the discovery of new treatments. Yet, the only option currently available to counteract the emergence of superbugs is through effective infection prevention and control. These tactics necessitate halting the practice of over-prescription and the misuse of antibiotics by medical professionals, as well as ensuring that patients use prescribed antibiotics appropriately by taking them as indicated, finishing the specified course, and not sharing them. 

In the agricultural industries, limiting the use of antibiotics to the treatment of sick livestock only, and not utilizing them as growth factors for animals might be critical in the battle against antimicrobial resistance. 

Presently, greater innovation and investment is required in operational research, as well as in the research and development of new antibacterial drugs, vaccines, and diagnostic tools, particularly those targeting critical gram-negative bacteria like carbapenem-resistant Enterobacteriaceae and Acinetobacter baumannii. 

The Antimicrobial Resistance Action Fund, the Antimicrobial Resistance Multi-Partner Trust Fund, and the Global Antibiotic Research and Development Partnership may address financial gaps in the funding of research initiatives. Several governments, including those of Sweden, Germany, the United States, and the United Kingdom, are testing reimbursement models to develop long-term solutions in the fight against superbugs.

Implications of superbugs

Wider implications of antibiotic resistance may include:

• Longer hospital stays, higher medical costs, and increased mortality.


• Organ transplant surgeries becoming increasingly dangerous since immuno-compromised organ recipients may not be able to fight off life-threatening infections without antibiotics.


• Therapies and procedures such as chemotherapy, caesarean sections, and appendectomies becoming significantly more dangerous without effective antibiotics for the prevention and treatment of infections. (If bacteria get into the bloodstream, they can cause life-threatening septicemia.)


• Pneumonia becoming more prevalent and may return as the mass killer it once was, particularly amongst the elderly.


• Antibiotic resistance in animal pathogens that can have a direct negative effect on animal health and welfare. (Contagious bacterial diseases can also cause economic losses in food production.)

Questions to consider

• Do you think that the battle against superbugs is a matter of science and medicine or a matter of society and behavior?


• Who do you think needs to lead behavior change: the patient, the doctor, the global pharmaceutical industry, or policymakers?


• Considering the threat of antimicrobial resistance, do you think that practices such as antimicrobial prophylaxis for healthy people “at-risk” should be allowed to continue?