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.
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