Global Importance of Antibiotics and Consequences of Antibiotic Overuse

From birth to death, antibiotics are indispensable to treat everyday bacterial infections and the unavoidable infections that come with cancer chemotherapy and organ transplantations. All use of antibiotics contributes to resistance, so apart from human use, the role of antibiotic use in animals and food production in driving resistance in human infections and the spread of resistance must be addressed. The spread of ABR, coupled with the lack of novel antibiotics, is threatening health systems globally. It has been fuelled by massive use and misuse of antibiotics together with poor sanitation and lack of hygiene and infection control. Polluted environments from aquaculture, agriculture, wastewater from municipalities, pharmaceutical manufacturing and hospitals also contribute to the emergence and spread of ABR. All these factors contribute to the evolution of multiple drug resistance in bacteria and spread of resistance genes across soil, water and air. ABR is part of a larger ecological phenomenon and solutions need to encompass both technical interventions and changes in behaviour.

Resistant bacteria do not respect borders and in a globalized world of trade and travel, the spread these bacteria is a stark reality of our interconnected world. Intensified human mobility and food trade accelerate the spread of ABR across national borders and across different bacterial species, from bacteria in animals to those in humans. Responding to outbreaks of resistant infections need to involve coordination of efforts across national boundaries, varied health systems and international agencies like the WHO.

There is a paucity of data, especially from low- and middle-income countries on the aggregated health and economic burden of ABR. Despite this, ABR is currently considered one of the world’s greatest public health threats and also an economic and environmental risk.