Antibiotic-resistant infections set to claim millions of lives by 2050, global study warns
A groundbreaking analysis published in The Lancet predicts a steep rise in deaths from antimicrobial resistance, with older adults most at risk. The study offers a stark reminder of the urgent need for global action to combat this growing threat.
Global deaths from antimicrobial resistance (AMR) are projected to surge by nearly 70% over the next quarter-century, potentially claiming more than 39 million lives between now and 2050, according to a comprehensive new study published in The Lancet on 16 September 2024. The research, conducted by the Global Research on Antimicrobial Resistance (GRAM) Project, provides the first in-depth analysis of global AMR trends from 1990 to 2021 and forecasts potential impacts through 2050 for 204 countries and territories.
Historical trends and future projections
The study reveals that AMR has been a significant global health threat for decades, with more than one million people dying each year as a result of antibiotic-resistant infections between 1990 and 2021. The researchers estimate that by 2050, annual deaths directly attributable to AMR could reach 1.91 million, marking a stark increase of almost 70% compared to 2022 figures.
Dr Mohsen Naghavi, Team Leader of the AMR Research Team at the Institute of Health Metrics (IHME), University of Washington, USA, emphasised the importance of these findings: “Understanding how trends in AMR deaths have changed over time, and how they are likely to shift in future, is vital to make informed decisions to help save lives.”
Age-related shifts in AMR mortality
One of the study’s most striking revelations is the significant age-related shift in AMR deaths over the past three decades. While deaths among children under five years old declined by more than 50% between 1990 and 2021, those among people aged 70 years and older increased by more than 80%. This trend is expected to continue, with AMR deaths among children under five projected to halve by 2050 globally, whilst deaths among those 70 years and older are predicted to more than double.
Dr Kevin Ikuta of the University of California Los Angeles (UCLA) and affiliate professor at IHME commented on this shift: “The fall in deaths from sepsis and AMR among young children over the past three decades is an incredible achievement. However, these findings show that while infections have become less common in young children, they have become harder to treat when they occur.”
Regional variations and high-risk pathogens
The study identified five global regions where annual deaths directly from AMR increased by more than 10,000 between 1990 and 2021: western sub-Saharan Africa, Tropical Latin America, high-income North America, Southeast Asia, and South Asia. South Asia is projected to bear the highest burden, with an estimated 11.8 million deaths directly due to AMR forecast between 2025 and 2050.
The research also highlighted increasing resistance to critically important antimicrobials. Deaths due to methicillin-resistant S. aureus (MRSA) more than doubled globally, from 57,200 in 1990 to 130,000 in 2021. Among Gram-negative bacteria, resistance to carbapenems increased more than any other type of antibiotic, rising from 127,000 deaths in 1990 to 216,000 in 2021.
Potential for intervention
Despite the grim projections, the study offers hope by modelling alternative future scenarios. The researchers estimate that improving overall infection care and access to antibiotics could prevent 92 million deaths between 2025 and 2050. The greatest benefits would be seen in South Asia, sub-Saharan Africa, and parts of Southeast Asia, East Asia, and Oceania.
Dr Stein Emil Vollset of the Norwegian Institute of Public Health and affiliate professor at IHME stressed the urgency of the situation: “To prevent this from becoming a deadly reality, we urgently need new strategies to decrease the risk of severe infections through vaccines, new drugs, improved healthcare, better access to existing antibiotics, and guidance on how to use them most effectively.”
Study limitations and future research needs
The authors acknowledge several limitations to their study, including a lack of data for some low- and middle-income countries and potential errors or biases in the 520 million individual records used to produce the estimates. They call for improved data collection and infrastructure investment to strengthen estimates for these countries and improve the accuracy of future AMR forecasts.
As the global community grapples with the growing threat of AMR, this landmark study serves as a crucial wake-up call. It underscores the need for concerted action on multiple fronts – from developing new antibiotics and improving access to existing ones, to enhancing infection prevention and control measures. With millions of lives at stake, the time for decisive action is now.
Reference:
GBD 2021 Antimicrobial Resistance Collaborators. (2024). Global burden of bacterial antimicrobial resistance 1990–2021: a systematic analysis with forecasts to 2050. The Lancet. https://doi.org/10.1016/S0140-6736(24)01867-1
