Each year, an estimated 7.7 million deaths are caused by bacterial infections, making them the second largest cause of death globally. Alarmingly, almost 5 million of these deaths are linked to bacteria that have developed resistance to antibiotics. This growing resistance is a significant threat, particularly in low- and middle-income countries (LMICs). However, a new series in Lancet shows that improving and expanding existing methods to prevent infections, such as hand hygiene, regular cleaning and sterilisation of equipment in healthcare facilities, availability of safe drinking water, effective sanitation and use of paediatric vaccines, could prevent these deaths.
AMR AND VULNERABLE POPULATIONS
The most vulnerable groups, including babies, children, the elderly, and people with chronic illnesses, face higher risks from AMR. For instance, a third of deaths in newborns are caused by infections, with many bacteria no longer responding to available antibiotics. The elderly and those with chronic conditions are also at significant risk, especially during medical treatments in hospitals and long-term care facilities.
STRATEGIES TO COMBAT AMR: PREVENTING INFECTIONS
1. Improving Infection Control in Healthcare Facilities
Enhancing hand hygiene, regular cleaning, and sterilization of equipment can significantly reduce infection rates. These measures could save up to 337,000 lives annually by preventing infections and reducing the need for antibiotics, thereby lowering the selection pressure for AMR.
2. Ensuring Access to Safe Water and Sanitation
Universal access to safe drinking water and effective sanitation is crucial. These interventions could prevent approximately 247,800 deaths each year by reducing the spread of infections in community settings.
3. Expanding Vaccination Programs
Vaccination is a powerful tool in preventing infections. Expanding the rollout of paediatric vaccines, such as pneumococcal vaccines, and introducing new ones like RSV vaccines for pregnant mothers, could save 181,500 lives annually. Vaccines reduce the incidence of bacterial infections, thus decreasing antibiotic use and the development of resistance.
CHALLENGES AND THE NEED FOR NEW APPROACHES
Ensuring sustainable access to effective antibiotics is essential. Traditional drug development models, driven by high profits, are failing to deliver new antibiotics, especially in LMICs. Public-private partnerships and increased funding for AMR prevention programs are necessary to make new antibiotics affordable and accessible globally.
ANTIBIOTIC STEWARDSHIP
Reducing inappropriate antibiotic use is critical. Antibiotic stewardship programs aim to limit the use of antibiotics when the benefits are minimal, thus reducing the selection pressure on bacteria to develop resistance. However, more research is needed to understand the impact of these programs, particularly in LMICs.
AMBITIOUS GOALS FOR 2030
The Lancet Series proposes the ‘10-20-30 by 2030’ goals to address AMR:
- 10% Reduction in AMR Mortality: Achieved by scaling up public health interventions to prevent infections.
- 20% Reduction in Inappropriate Human Antibiotic Use: Targeting reductions in antibiotic use for mild respiratory infections.
- 30% Reduction in Inappropriate Animal Antibiotic Use: Implementing policies to control antibiotic use in animal agriculture.
- The establishment of an Independent Panel on Antimicrobial Access and Resistance is recommended to expand the evidence base for policy implementation and inform new targets.
A CALL TO ACTION
The window of opportunity to tackle AMR is closing rapidly. Immediate action is required to ensure the effectiveness of antibiotics and protect global health. By improving infection prevention methods, ensuring sustainable access to antibiotics, and implementing robust antibiotic stewardship programs, we can combat AMR and save millions of lives. The upcoming United Nations High-Level Meeting on AMR in September 2024 is a crucial moment to commit to these actions and secure a healthier future.
Addressing AMR requires a multifaceted approach involving healthcare professionals, policymakers, and society at large. By focusing on prevention, sustainable access, and responsible use of antibiotics, we can mitigate the impact of AMR and enhance global health security.