Antimicrobial resistance (AMR) stands as a looming global crisis that threatens our ability to effectively treat infections and diseases. Over time, bacteria, viruses, parasites, and fungi can develop resistance to medications like antibiotics, antivirals, antifungals, and antiparasitic drugs. This occurs when these microorganisms evolve and adapt, rendering the medications less effective or entirely ineffective.

Antibiotics, once hailed as miracle drugs, are increasingly becoming ineffective against microbes. It leads to approximately 5 million deaths in 2019 due to antimicrobial resistance (AMR). The overuse and misuse of antibiotics have caused pathogens to mutate, rendering these drugs ineffective against infections.

Causes

The causes of AMR are multifaceted, arising from overuse and misuse of antimicrobial drugs in human health, agriculture, and veterinary practices. The inappropriate prescription of antibiotics, their widespread use in agriculture for growth promotion in livestock, and inadequate hygiene and infection control measures all contribute to the acceleration of resistance.

Historical Context of Antibiotics

• Post-World War II witnessed mass production of antibiotics like penicillin, fueling global dependence on these medicines. However, discoveries of novel antimicrobials have stagnated since the 1980s, leading to a lack of effective new antibiotics.

AMR and its Implications

• AMR occurs when pathogens stop responding to medicines, making infections more challenging to treat, leading to severe illness and increased mortality rates.
• WHO classifies priority pathogens into critical, high, and medium categories, primarily Gram-negative bacteria causing severe infections like pneumonia.

Current Status and Concerns

• The drug pipeline for new antibiotics is dwindling, with only a few novel drugs targeting critical priority pathogens in clinical trials.
• Major pharmaceutical companies are pulling out of antibiotic research due to low returns, leading to concerns of ineffective current antibiotics, a lack of new drugs, and limited access to crucial medications.

Challenges in Antibiotic Research

• Big Pharma’s reluctance in antibiotic R&D stems from economic reasons such as high development costs and risks. Moreover, focusing on other diseases like cancer and diabetes yields higher profits.
• Access to novel antibiotics should be ensured while regulating their usage to combat AMR effectively.

Way Forward: Addressing AMR as a Global Public Good

• G-7 countries are incentivizing antibiotic research but emphasize the need for limited and responsible usage alongside affordability and accessibility.
• Consideration of antibiotics as a global public good might require new taxes on pharmaceutical profits, ensuring public research serves the common good.

Conclusion

The rise of AMR threatens global healthcare, necessitating urgent action to incentivize research, regulate antibiotic usage, and ensure equitable access to these vital drugs. Treating antibiotics as a global public good is a crucial step in combating this silent pandemic.

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