The invisible killer: what is antimicrobial resistance?

Medical illustration depicting carbapenem-resistant Enterobacteriaceae

Antimicrobial resistance is an invisible killer, directly responsible for 1.6 million deaths and indirectly for 5 million deaths each year. Everyone seems to have a family member or friend who has become seriously ill or even died of antimicrobial resistance. However, this threat can be addressed in many ways, including focusing on hygiene and sanitation, vaccination, and avoiding overuse or abuse of drugs.

On Thursday, the United Nations General Assembly convened a high-level meeting on antimicrobial resistance on the theme "Investing in the future: accelerating global, regional and national multisectoral action to address antimicrobial resistance." Here's what you need to know about antimicrobial resistance:

What are antimicrobials?

Antimicrobials (including antibiotics, antivirals, antifungals, and antiparasitic drugs) are drugs used to prevent and treat infections in humans, animals, and plants. Since their discovery a century ago, these drugs have been saving millions of lives every day, dramatically increasing the average life expectancy of humans until they no longer work.

What is antimicrobial resistance?

According to the World Health Organization, antimicrobial resistance occurs when bacteria, viruses, fungi, and parasites change over time and no longer respond to drugs. This makes infections more difficult to treat and puts them at an increased risk of disease transmission, severe illness, and death. Due to drug resistance, antibiotics and other antimicrobials become ineffective, making infections increasingly difficult or untreatable.

Antimicrobial resistance (AMR) is multifactorial, including the overuse and misuse of antimicrobials, the use of microbiomes in agriculture, poor infection control in healthcare and communities, and increased global trade and travel.

The dangers of antimicrobial resistance

Antimicrobial resistance can happen to anyone, anywhere, WHO said. Even if a person is in good health, a minor cut, a routine surgical procedure, or a common lung infection can become life-threatening due to drug resistance. For people who already have an underlying medical condition, a hard-to-treat infection can become a second major threat in their lives, which can strike at the most unexpected moment.

Antimicrobial resistance threatens individual health and can have severe economic, food safety, and development implications. It is estimated that antimicrobial resistance could lead to economic losses of up to US$3.4 trillion globally annually by 2030 and could push an estimated 28 million people into poverty by 2050.

Global Plan of Action

The good news is that antimicrobial resistance is entirely preventable. The international community adopted a global action plan in 2015 to raise public awareness, responsible use of antimicrobials, and ongoing research. Another effective tool is strengthening health systems by establishing universal health coverage, prioritizing infection prevention and control, immunization, and water, sanitation, and hygiene programs to reduce antimicrobials.

At the same time, WHO monitors, reports, and provides up-to-date information on resistant microorganisms. Earlier this year, WHO updated its list of drug-resistant microorganisms that pose the greatest threat to human health. Since the publication of the first Catalogue of Key Bacterial Pathogens in 2017, rising antimicrobial resistance has weakened the efficacy of many antibiotics, putting many of the achievements of modern medicine at risk.

WHO Assistant Director-General for Antimicrobial Resistance Takako Nakatani said the list maps the global burden of drug-resistant microorganisms and assesses their public health impact. It is critical to guide investment and respond to the antibiotic supply and access crisis.