Antimicrobial Resistance: A Threat to Modern Medicine and Global Health
As drug-resistant infections rise and the antibiotic pipeline dries up, antimicrobial resistance is quietly undermining modern medicine
Scientists working in the lab, via Wikimedia Commons
Antimicrobial resistance (AMR) happens when bacteria, viruses, fungi and parasites adapt to survive antimicrobial treatments, such as antibiotics. It is a fast-growing global health crisis that could make common infections untreatable.
“Dr Baker warns that AMR is one of the biggest challenges of the next century, but is often seen as a distant threat – until it suddenly isn’t.”
In 2019, bacterial AMR directly caused an estimated 1.27 million deaths and contributed to 4.95 million total deaths, but it remains underfunded despite its escalating threat. The UK Health Security Agency (UKHSA) reports a 3.5% rise in antibiotic-resistant bloodstream infections in the UK since 2019. It also reports that recorded cases of carbapenemase-producing organisms (CPOs) doubled between 2021 and 2023. CPOs are bacteria that have developed resistance to carbapenems, a class of last-resort antibiotics, making infections extremely difficult to treat. AMR disproportionately impacts low- and middle-income countries, with children in sub-Saharan Africa being 58 times more likely to die from drug-resistant infections than those in high-income nations.
Professor Andres Floto, co-leader of the Cambridge Infectious Diseases Interdisciplinary Research Centre, highlights that there are ‘difficulties in getting rapid diagnostics that could allow better selection of antibiotics, and this is a major area of current innovation.’ Until diagnostics improve, treatment delays and overuse of broad spectrum antibiotics will continue, further driving severe cases of AMR. Professor Floto also warns that ‘access to over-the-counter and online purchases of antibiotics without a prescription is a major problem around the world. Sharing antibiotics amongst family and friends is also a problem, as is use of antibiotics in agriculture in large parts of the world’. These practices expose bacteria to unnecessary doses of antibiotics, accelerating resistance and promoting drug-resistant strains.
“Dr Stephen Baker… explains that ‘we started to exhaust the avenues of identifying new antibiotics, but also every time we create a new antibiotic, we get resistance clinically within three years.’ ”
New antibiotic development is financially unviable for pharmaceutical companies, shifting the burden of discovery largely to academia, where progress is slow due to limited funding and challenges in translating research into real-world treatments. Dr Stephen Baker, molecular microbiologist at the Cambridge Institute for Therapeutic Immunology and Infectious Disease (CITIID), explains that ‘we started to exhaust the avenues of identifying new antibiotics, but also every time we create a new antibiotic, we get resistance clinically within three years.’
Credit: NIAID
AMR is already compromising the safety of surgery, cancer treatment and intensive care, Professor Floto warns. Resistant infections extend hospital stays, raise mortality risks and make procedures like organ transplants, chemotherapy and childbirth more dangerous by leaving patients vulnerable to severe, untreatable infections. Not only is it a major risk to public health, but also has far-reaching economic consequences, with the WHO estimating that AMR could cost the global economy up to $3.4 trillion per year by 2030.
A Wellcome Trust report calls for stronger global accountability and urges the UN to set a unified goal for reducing AMR. To strengthen the global response to AMR, they propose a scientific evidence panel to track progress, analyse data and provide policy recommendations based on the latest research. They also call for regular international policy reviews to keep AMR a global health priority and hold governments accountable for their commitments. Global education campaigns are essential to reducing antibiotic misuse and raising awareness to slow the spread of AMR.
Funding initiatives like the AMR Action Fund and CARB-X support antibiotic research, but long-term incentives and policy action are needed to sustain the development of new, effective treatments. The UK’s National AMR Action Plan (2024-2029) aims to reduce antimicrobial use, improve infection prevention measures and strengthen hospital infection controls to combat drug-resistant infections. The UKHSA’s report notes improvements in antimicrobial stewardship, which ensures that antibiotics and other drugs are used effectively and responsibly. However, the report also highlights gaps in hospital infection control, with resistant bacteria still spreading widely between patients.
Dr Baker notes that antimicrobial peptides, bacteriophages and monoclonal antibodies all have potential as alternative treatment options. However, these approaches are not broad-spectrum antimicrobials, tend to be costly to manufacture and are more suitable for smaller patient groups rather than widespread use. A lack of scalability is preventing their development and implementation.
AMR is already killing millions of people each year, and without urgent action, the death toll will keep rising as drug-resistant infections become harder to treat. It means that routine procedures like surgery, chemotherapy and organ transplants are a growing risk, while antibiotic development is slowing due to economic disincentives for pharmaceutical companies. Global governance must step up to address the AMR crisis and implement stronger policies, accountability measures and international collaboration.
Dr Baker warns that AMR is one of the biggest challenges of the next century, but is often seen as a distant threat – until it suddenly isn’t. There is an urgent need for proactive intervention before it spirals out of control. Like climate change, AMR is a creeping but devastating global crisis that requires urgent, coordinated action to prevent catastrophic consequences for public health and modern medicine.