Antibiotic-resistant superbugs in spotlight at high-level UN meeting

The United Nations General Assembly will hold a historic, high-level meeting on Wednesday to discuss a plan to fight antibiotic-resistant superbugs.

We fall sick when bacteria infect us and we take antibiotics to fight off those infections, but bacteria can evolve to withstand antibiotic drugs.  

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And the medical world is losing the ability to keep ahead of microbial resistance. Antimicrobial resistance in bacteria, viruses and fungi already kills 700,000 people worldwide each year, according to a report to the British government.

On Wednesday at the UN General Assembly, world leaders will talk about ways to fight antimicrobial resistance. It's rare for a health topic to reach this level at the UN. The Ebola and HIV epidemics and noncommunicable or chronic diseases such as heart attacks and stroke, cancer, diabetes and asthma were the other instances. 

"By the year 2050, it's been estimated that more people will die from these kinds of infections than die from cancer today," said Keiji Fukuda, special representative for antimicrobial resistance in the office of the World Health Organization's director general.

When bacteria resist all available antibiotics, routine surgeries such as C-sections and transplants or chemotherapy will become more dangerous without an effective way to keep infections at bay, said Ramanan Laxminarayan, director and senior fellow at the Center for Disease Dynamics, Economics and Policy in Washington.

"The average citizen has probably never met someone who died of a drug-resistant infection," Laxminarayan said. "But they probably know someone who's died of what's called a multi-organ failure or died in a hospital of an infection that couldn't be treated."

Outbreaks such as Ebola or Zika generate headlines, but antimicrobial infections haven't grabbed the attention of government and state leaders the same way, said Dr. Andrew Morris, director of antimicrobial stewardship at Sinai Health System and Toronto's University Health Network.

"There are no walks, runs, bike rides, golf tournaments for antimicrobial resistance or antimicrobial stewardship," Morris said. "I think part of that is our fault for not educating the public on why it's such a huge issue."

Rise of drug-resistent infections

Morris said that when he trained 20 years ago, patients with infections where the treatment option was limited to one or two antibiotics was almost unheard of. "Now we see drug-resistant infections every single day."

Fukuda hopes the UN meeting about antimicrobial resistance will galvanize the attention of presidents and prime ministers around the world and lead them to find the money and political will to act on a problem that demands co-ordination from the health, agricultural and economic development sectors.

Individuals also need to use antibiotics in a responsible way, which will require the kind of culture shift that second-hand smoking faced, he said.

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Adding to the complexity, drug-resistant infections come in a variety of guises, from urinary tract infections, blood infections, skin infections, pneumonia, sexually transmitted infections such as gonorrhea, as well as diseases like tuberculosis and malaria, Fukuda said.

'Countries are now on notice'

There is no way to enforce a UN resolution, Laxminarayan acknowledged. 

"Countries are now on notice," said Laxminarayan. "If they fail to act, the consequences are basically the dismantling of modern medicine as we know it. It all depends on effective antibiotics."

The UN spotlight lends support to individuals, professional societies and patients because it offers "a document to put in front of governments and say, 'You promised to do this and people are dying because you have not acted.'"

At the meeting, delegates will talk about solutions such as:

• Reducing the use of antibiotics in animal agriculture.
• Discovering new ways to kill bacteria.
• Finding ways to make new drugs economically viable and available to everyone who needs them.

On Tuesday, 13 drugmakers pledged to clean up pollution from factories making antibiotics and take steps to curb overuse of the medicines as part of the effort.

Companies that have signed on include branded and generic drug leaders, including Pfizer, Merck, Novartis, GlaxoSmithKline and Allergan, as well as Indian drug maker Cipla.

Their efforts to prevent overuse of antibiotics will involve a review of promotional activities and the implementation, by 2020, of concrete measures such as the removal of incentives to sell the drugs in larger volumes.