With increasingly common drugs losing their ability to fight dangerous infections and with few new drugs in preparation, the UN has warned that the world is facing an impending crisis that can lead to millions of deaths, an increase in global poverty and an even greater increase . difference between rich and poor countries.
Drug-resistant infections already reach 700,000 lives a year, including 230,000 deaths from drug-resistant tuberculosis, according to the UN report.
Overuse of antibiotics and antifungal medicines in humans, livestock and agriculture is accelerating a crisis that the UN fears is poorly understood by the public and widely ignored by world leaders.
Without concerted action, according to a UN panel, resistant infections could kill 10 million people annually by 2050 and trigger an economic slowdown that would rival the global financial crisis of 2008.
The problem threatens people around the world. Over the next 30 years, according to UN experts, 2.4 million people in Europe, North America and Australia could die from drug-resistant infections, making routine hospital procedures such as knee replacement surgery much riskier which they are today.
Dr. Haileyesus Getahun, Director of the United Nations Inter-Agency Coordination Group on Antimicrobial Resistance, spent two years working on the report and called for a "silent tsunami".
"We are not seeing the political impetus we have seen in other public health emergencies, but if we do not act now, antimicrobial resistance will have a disastrous impact on a generation," Getahun said.
The group, a collaboration of public health experts, government ministers and industry officials, called for the creation of an independent body with the stature and funding of the UN panel on climate change.
The dire predictions of the report seek to raise public awareness and stir political leaders into action.
He proposes a series of measures that, according to health officials, may help contain the emergence of drug-resistant pathogens.
The recommendations include a worldwide ban on the use of medically important antibiotics to promote the growth of farm animals, financial incentives for pharmaceutical companies to develop new antimicrobial compounds and stricter rules to limit the sale of antibiotics in countries where drugs can be purchased with convenience stores without a prescription.
The report also highlights factors not appreciated in the spread of drug-resistant germs: lack of clean water and inadequate sewage systems that sick millions of people in the developing world.
Many of them are too poor to consult a doctor and instead buy cheap antibiotics from street vendors with little medical experience.
Sometimes, unknowingly, they buy counterfeit drugs, a problem that leads to millions of deaths, most of them in Africa.
To reduce infectious disease outbreaks, the report says, wealthier nations should help poor countries pay for improvements in public health and ensure greater access to properly manufactured vaccines and antibiotics.
Health officials are struggling to understand the scope of the problem because many countries are poorly equipped to monitor drug-resistant infections.
In a UN survey of the report, 39 out of 146 nations were unable to provide data on the use of antimicrobials in animals, which experts say is an important resistance factor in humans as resistant bacteria are transferred to people through contaminated food. Water.
"We are very blind and working hard to get a clear view," said England's chief medical officer Sally Davies.
As a first step, the report calls on UN member states to develop national management plans to reduce unnecessary use of antimicrobials.
A key element of the report is a call for new incentives to encourage the development of antimicrobial medicines.
Between 2010 and 2014, six new antimicrobials were approved, most of them additions to existing drug classes, according to the World Health Organization.
On the other hand, 19 new antimicrobials were approved between 1980 and 1984.
The shortage of new drugs is linked to the perverse economy of antimicrobial resistance and the free market.
It may cost half a billion dollars to develop a new compound, but doctors are discouraged from using the drugs to reduce the chance that target pathogens will become resistant.
Even when doctors prescribe drugs, most patients take them for a week or two, limiting a pharmaceutical company's ability to recoup its initial investment.
"Everyone agrees that there is an absolute need for new antibiotics, but there is no sustainable market," said Thomas Cueni, director general of the International Federation of Pharmaceutical Manufacturers and Associations.
Incentives for new drug development may include generous government funding for research, or regulatory changes that would increase reimbursements for newly approved antibiotics considered clinically important.
According to the World Bank, these investments would pay off quickly; notes that containment of antimicrobial resistance costs $ 12.7 billion per year.
Cueni, who also chairs the AMR Industry Alliance, a trade group working to address the problem of antimicrobial resistance, said more funding is needed.
"I applaud the UN at least for putting incentives on the map, but it takes more than talking," he said.
Still, many public health advocates said the report was an important step in raising a crisis that failed to catch the attention of other global problems such as climate change and AIDS.
Lance Price, director of the Center for Action Against Antibiotic Resistance at George Washington University, said he was concerned that the report would not gain much strength from the Trump government, which has been averse to multilateral cooperation.
Fear, he said, was the key to changing the status quo.
"Even if you do not mind the suffering of people who drink dirty water and have resistant infections, you still need to recognize that these bacteria do not recognize international borders," he said.
"They will come here and kill us. We have to let people know that the problem is closer than they think.
By Andrew Jacobs © 2019 The New York Times