Publication:

The silent pandemic: understanding the global burden of antimicrobial resistance

Antimicrobial resistance (AMR) is one of the most severe public health concerns of the 21st century and is reversing decades of progress made in the prevention and treatment of infectious diseases. AMR is a so-called "silent pandemic" since the condition progresses slowly and is completely unnoticed. But even AMR worldwide leads to considerable health, mortality and economic losses, with the most recent global report showing millions of such infectious diseases worldwide, and a very high number of deaths resulting from them, most of which are in the low- and middle-income countries. This review presents a global picture of AMR, clinical and public health-related issues along with key issues in terms of epidemiological surveillance, innovation and policy response. Factors driving the emergence and spread of resistance include the overuse and inappropriate use of antibiotics in human and animal health, poor infection control, substandard drugs, and environmental pollution. Also, we report that the health care sector is at significant risk due to AMR, which is a serious threat to the outcomes of routine surgeries, organ transplants, cancer treatment and the care of vulnerable patients. This in turn places substantial strain on health care systems. Worldwide and in different regions, monitoring programmes have been established that use genomics and Artificial Intelligence (AI) to study resistance pattern although they are still in a developing stage. Also, the development of new antibiotics in the pharma sector is a limited field, which in turn is pushing research into alternative options like phage therapy, nanotech-based solutions, Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) and vaccines that target priority pathogens. Although the World Health Organisation’s (WHO) Global Action Plan and national AMR strategies play a key role in shaping the international policy landscape for this issue, significant gaps still exist in implementation, regulation, financing and stewardship. The solution lies in better data collection on health issues, responsible use of antibiotics, infection control, innovation and sustained political commitment, which will not only slow down the AMR pandemic but also help secure the health of future generations.