A microbiologist at the Max-Planck-Institute for Infection Biology prepares a bacterial colony of the strain Streptococcus pyogenes on a blood agar plate.
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Already recognized as one of the leading public health threats facing humanity today, it is feared that a warming world is making it harder to stop the insidious spread of drug-resistant superbugs.
Antimicrobial resistance (AMR), which the World Health Organization has referred to as the “silent pandemic,” is an often ignored and growing global health crisis.
The United Nations health agency has previously declared AMR to be one of the top 10 global threats to human health and says an estimated 1.3 million people die every 12 months directly due to resistant pathogens.
That figure is heading in the right direction to “soar dramatically” without urgent motion, the WHO says, leading to higher public health, economic and social costs and pushing more people into poverty, particularly in low-income countries.
Antimicrobials, which include life-saving antibiotics and antivirals, are medicines used to prevent and treat infections in humans and animals. Their overuse and misuse, nevertheless, is understood to be the chief driver of the AMR phenomenon.
AMR occurs when microorganisms reminiscent of bacteria, viruses, fungi and parasites develop the ability to persist and even grow despite the presence of drugs designed to kill them.
People have a look at the wildfire raging in a forest in Sikorahi, near Alexandroupoli, northern Greece, on August 23, 2023.
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Making matters worse, research has shown that climate change is exacerbating the AMR crisis in several ways.
“Climate change is intrinsically essential because of what is going on on with our planet and the problem is that the more our temperatures rise, the more infectious diseases can transmit — and that features AMR bacteria,” Tina Joshi, associate professor of molecular microbiology at the U.K.’s University of Plymouth, told CNBC via videoconference.
“AMR bacteria is referred to as a silent pandemic. The explanation its referred to as silent is that nobody knows about it — and it’s really sad that nobody seems to care,” Joshi said.
A ‘completely broken’ diagnostics pipeline
A report published by the UN Environment Program earlier this 12 months, entitled “Bracing for Superbugs,” illustrates the role of the climate crisis and other environmental aspects in the development, spread and transmission of AMR.
These include higher temperatures being related to the rate of the spread of antibiotic resistant genes between microorganisms, the emergence of AMR due to the continuing disruption of extreme weather events and increased pollution creating favorable conditions for bugs to develop resistance.
Scientists said earlier this month that a unprecedented run of global temperature records means 2023 is “virtually certain” to be the warmest 12 months ever recorded. Extreme heat is fueled by the climate crisis, which makes extreme weather more frequent and more intense.
It kind of boils down to the proven fact that it’s not economically viable to actually put money into antibiotics and their development. And that’s something that’s rocking the antimicrobial world.
Tina Joshi
associate professor of molecular microbiology at the University of Plymouth
Robb Butler, director of the division of communicable diseases, environment and health at WHO Europe, described AMR as “a particularly pressing global health challenge.”
“It’s an enormous health burden and it costs just the EU member states somewhere in the region of 1.5 billion euros ($1.6 billion) every year in health costs but in addition in loss of productivity. So, it’s an exceptional challenge,” Butler told CNBC via telephone.
Butler said he hoped the upcoming COP28 climate conference in the United Arab Emirates could provide a platform for international policymakers to start to recognize the association between the climate crisis and AMR. The UAE will host the U.N.’s annual climate summit from Nov. 30 through to Dec. 12.
“The issue is that, of course, antibiotics or antimicrobials, usually are not that attractive for industry to develop. They’re expensive, they’re high-risk — and we’ve not seen over the last 20 years antimicrobial drugs developed with enough unique characteristics to avoid resistance.”
“We hear people talking about this ‘silent pandemic,’ but it should not be silent. We should always be making more noise about it,” Butler said.
“You’ll imagine the [coronavirus] pandemic might have been a wake-up call, but we still don’t see enough attention to AMR.”
A petri dish remarking on the bacterial contamination of tray tables at the booth for Polygiene AB, which offers antimicrobial, antibacterial and anti odor technology, at the Aircraft Interiors Expo in Hamburg, Germany, on Wednesday, June 15, 2022.
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Butler said that perhaps his biggest concern was how to incentivize industry leaders to tackle AMR at a time after they are fully aware they might be higher off investing in other research and development areas — reminiscent of producing a highly profitable obesity drug, for instance.
“For me, that is the one which keeps me awake at night,” Butler said. “I can take into consideration how society might change through shocks to more prudently use antibiotics in order that we do not construct resistance to antibiotics. But when there is completely nothing in the pipeline with progressive characteristics then we have kind of lost,” he added. “And that actually, really concerns me.”
The University of Plymouth’s Joshi echoed this view, describing the AMR diagnostics pipeline as “completely broken” and calling for policymakers to urgently reinvigorate this process.
“It isn’t profit-making,” she added. “It kind of boils down to the proven fact that it’s not economically viable to actually put money into antibiotics and their development. And that’s something that’s rocking the antimicrobial world.”
The following pandemic?
Thomas Schinecker, chief executive of the Swiss pharmaceutical company Roche, said last month that policymakers were at risk of failing to learn the crucial lessons from the coronavirus pandemic — adding that this might have serious ramifications for the AMR health crisis.
“I don’t think that we have now learned the lessons that we must always have learned in the last pandemic, and I do not think we’re higher prepared for the next pandemic,” Schinecker told CNBC’s “Squawk Box Europe” on Oct. 19.
“I feel it is significant that we take those learnings, that we implement what we’d like to do to be prepared because the next pandemic will come,” he continued.
“One of the concerns I actually have is that potentially antibiotic resistant bacteria may very well be that pandemic. With that, we’d like to deal with preparing for such situations in the future.”