‘Numbers are going to inexorably rise’: Dame Sally Davies warns ‘superbugs’ will kill 39m by 2050

Deaths caused by drug-resistant infections like MRSA and E. Coli is set to boom in the coming decades, a major new study has predicted

More than 39 million people will die due to antimicrobial-resistant infections over the next 25 years, a major new study has predicted. 
Known as the ‘silent pandemic’, antimicrobial resistance (AMR) happens when bacteria, viruses, and other pathogens evolve to evade the drugs used to treat them. 
The new study, which was partly funded by the British government, found that AMR is now responsible for 1.14 million deaths every year – higher than the combined toll of HIV/Aids and malaria.
It predicts the number of annual deaths will almost double by 2050 to 1.91 million. 
Driven in part by the overuse and misuse of antibiotics in medicine and agriculture, the exponential rise in ‘superbugs’ puts modern medicine at risk. 
In England alone, 58,224 people had an antibiotic-resistant infection in 2022, up by 4 per cent from the previous year.
It means that common infections are becoming untreatable and routine surgeries and procedures – like caesarean sections, hip replacements, organ transplants, and chemotherapy – are becoming much riskier. 
Last year, the Telegraph featured two people whose lives had been irrevocably changed by AMR.
The new research, published in The Lancet by the Global Research on Antimicrobial Resistance (GRAM), is based on data from 204 countries and 520 million hospital records.
It found deaths from drug-resistant ‘superbugs’ – including dangerous strains of pneumonia, E.Coli, and C.diff – have increased most in North America, western sub-Saharan Africa, Latin America, and South and Southeast Asia. 
The top drug-resistant killer is methicillin-resistant S. aureus (MRSA) – a lethal superbug famed for plaguing hospital wards – which caused 130,000 deaths in 2021, more than doubling from 57,200 in 1990. 
Whilst the death toll from AMR is expected to almost double by 2050, this is only for “direct” deaths – deaths where a superbug has killed an otherwise healthy person.
The number of predicted “associated” deaths is much higher still, adding a further 8.22 million deaths per year. 
The groups most at risk from “associated” deaths are the elderly and others whose immune systems are compromised.
“The numbers are going to inexorably rise, and we are not where we need to be in tackling the problem,” Dame Sally Davies, the UK Special Envoy on AMR and former chief medical officer told The Telegraph. 
“It’s particularly bad in Sub-Saharan Africa and Asia, and it looks as if it is going to continue to get worse, which leads to a worry about how to support those countries to develop their vaccine programs, cleanliness, and access to antibiotics” added Dame Davies. 
One of the major issues with AMR is the slow pace of discovery of new antibiotics. Drugs companies are not incentivised to invest as the new antibiotics would – by definition – only be used as a last resort, drastically limiting profits.
Currently, just 27 new antibiotics for the most threatening infections are in the final stage of development. This compares to more than 1,300 cancer drugs in clinical trials in 2020. 
Without a robust pipeline of new antibiotics, there are dwindling treatment options in the face of rising drug-resistance.
Guy Hutton, a Senior Advisor at Unicef and researcher at WaterAid told The Telegraph, said there needed to be a focus on infection control as well as drug development.
“New drugs are important as one line of defence, but we need to implement better infection prevention by improving access to clean water – otherwise we will never get the problem of AMR under control,” he said.
A lack of clean water is a major contributor to the spread of resistant infections, and currently around 700 million people – mostly in Africa – do not have access. Unhygienic conditions spread disease, and in turn the need for drugs like antibiotics. 
In better news, AMR-related deaths have decreased by 50 per cent in children under five since 1990 and will continue to do so, according to the study.
The researchers attributed that fall to “major improvements” in the delivery of infection and control measures – such as widespread vaccination programmes – among infants and children. 
Some have questioned those findings, however. Dr Tim Walsh, director of biology at the Ineos Oxford Institute for Antimicrobial Research, said the GRAM study has “hugely underestimated” the number of children that die from resistant infections in the developing world. 
In Africa, mutant strains of tuberculosis and malaria that have become resistant to antibiotics and other antimicrobials are of particular concern. 
“Neonatal sepsis and mortality due to drug resistance is still very high, and although we have good data from places like the US, Europe, and Southeast Asia, there are a huge number of countries around the world where we simply don’t know the numbers,” said Prof Walsh. 
Sub-Saharan Africa has the least comprehensive antimicrobial surveillance strategies of anywhere in the world – and only 15 per cent of countries in the WHO African region carry out regular surveillance for bacterial antimicrobial resistance, meaning thousands of cases are likely missed. 
In newly published research, the charity WaterAid suggested that 1.5 million children die of drug-resistant infections in Africa alone – a figure at least eleven times higher than the GRAM estimates. 
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