Rise of drug-resistant superbugs could make Covid pandemic seem 'minor', expert warns global development


Professor Dame Sally Davies, England's former chief medical officer, has warned that the Covid-19 pandemic will “seem minor” compared to what humanity faces from rising numbers of superbugs resistant to current drugs.

Davis, who is now the UK's special envoy on antimicrobial resistance (AMR), lost her granddaughter two years ago to an infection that could not be treated.

Painting a bleak picture of what could happen if the world fails to tackle the problem within the next decade, he warned that the issue is even more serious than climate change. Drug-resistant infections already kill at least 1.2 million people per year.

“It seems that many people are suffering from infections that cannot be treated, and we need to isolate those who cannot be treated so that they do not infect their families and communities. So it's a really devastating picture. “This will make Covid seem trivial to some,” said Davis, who is also the first female master of Trinity College, Cambridge.

Sally Davis at Trinity College, Cambridge, where she is the first woman to become master. Photograph: Urszula Soltys/The Guardian

AMR means that certain infections caused by bacteria, viruses, fungi and parasites can no longer be treated with available drugs. Exposure to drugs causes insects to develop resistance to them, and overuse of drugs like antibiotics accelerates that process.

Widespread resistance would make modern medicine too risky, affecting treatments including cesarean sections, cancer interventions and organ transplants.

“If we don't make good progress over the next 10 years, I'm really scared,” Davis said.

Without the development of new treatments “it will grind on for decades and will not go away.” “We know that viruses die out, you usually develop herd immunity, but that is not the case.”

Last week the UK government announced a national action plan on AMR, including reducing the use of antimicrobials in both humans and animals, strengthening surveillance of drug-resistant infections, and encouraging industry to develop new drugs and vaccines. Commitments are included.

Launching the plan, Health Minister Maria Caulfield said: “As the world recovers from the deep impact of the COVID-19 pandemic, the importance of international cooperation and preparedness for global health challenges is at an unprecedented level.”

Davis has spent more than a decade warning about the problem, but she said it really hit home when her “beautiful” granddaughter, Emily Hoyle, died of a drug-resistant infection at the age of 38. Went.

Hoyle had cystic fibrosis and had two lung transplants before becoming infected mycobacteroids abscessusWhich was resistant to treatment.

The team treating him “tried everything,” Davis said. “But I would think to myself, looking back at the year before he died, I thought it would probably kill him.

Emily Hoyle, Dame Sally Davis' 'beautiful' granddaughter, has died of drug-resistant infection aged 38. Photograph: Courtesy John Hoyle

“And she knew about six months before she died that it would not be curable and that she would probably die from it.

“Her death was very beautiful – she was very dignified, laughing, joking, telling her husband, family, all of us about it. She was very special.

“But she gave me permission to use her story as my granddaughter because, well, it became personal to me, before last Christmas.”

Davis called it a question of intergenerational fairness, saying Hoyle's death had strengthened his determination to turn the situation around.

“My generation and older people have used antibiotics [and] We are not compensating them. We are not ensuring that our food is produced with as little use as possible. And I owe it to my children and – if I have them – grandchildren and to do my best for the next generations.”

Two plates containing an antibiotics disk and a bacterial culture. On the left, the bacteria are sensitive to the drugs and cannot grow near the disc; On the right they are resistant. Photo: Alamy

He said that in today's era there are also issues of fairness. One in five deaths caused by AMR is in a child under the age of five, most commonly in sub-Saharan Africa, where Davis said the problem is “particularly prevalent and devastating.”

Many countries are also being badly affected by the climate crisis and Davis said the two problems are interconnected.

“If we don't control and reduce AMR, it will kill more people than ever before due to climate change,” he said.

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“Climate will impact in many ways, but think about flood water, think about sewage, think about displacement, think about storms and what they spread and the lack of clean water if you have a drought. Think about; The infection increases.”

There are global efforts to reduce the inappropriate use of drugs such as antibiotics in medicine, although the COVID-19 pandemic has halted progress on many of those initiatives. Few new antibiotics have been created in recent years and the issue has been “made more complex” as it involves areas such as farming as well as human health.

More than two-thirds of the antibiotics go to farm animals, Davis said, usually to promote growth or prevent infections in crowded, unsanitary conditions rather than to treat specific infections.

A piglet was injected with antibiotics on a farm in the UK. Most antibiotics end up in farm animals, even though up to 80% is excreted, contaminating water systems. Photograph: Bloomberg/Getty

Some Asian fish farms are “giving antibiotics with the fish meal,” he said, partly because it's cheaper, but also because of a lack of research on what infections cause local fish breeds like tilapia. What other vaccines can be administered? Needed.

“If you don't have proper, careful use,” she said, “you risk it really getting out of control.”

She points out that animals, including humans, excrete up to 80% of the antibiotics they take, “contaminating the environment”. Factories making antibiotics cannot control their effluents, allowing “dramatic amounts” to enter water systems.

Despite her caveats, Davis insists that she is a “glass half full” person, brimming with enthusiasm as she discusses projects that find a different approach. A major US poultry supplier has stopped using antibiotics, “so you can do the same”, he said.

Breakthroughs like genomics and artificial intelligence are “reviving” the science of new antibiotics. He also hopes that programs to encourage pharmaceutical companies to create new antibiotics will be fruitful.

Ideally, such drugs should be reserved as a last resort if existing drugs fail to work, so that insects do not develop resistance to them. However, this makes it difficult for companies to guarantee returns on investments in research and development.

An electron micrograph of pseudomonas aeruginosa In an Australian laboratory. Few new antibiotics are being created, although superbugs are increasing rapidly. Photograph: Dave Hunt/AAP

Various countries are exploring alternative means of funding, such as a subscription model by NHS England, paying a fixed annual fee for access to antimicrobials, regardless of the quantity used.

Davis is part of the UN Global Leaders Group on AMR. In September, the UN will hold a high-level meeting on the issue and the group is pushing for targets by 2030, including reducing global human deaths from AMR by 10%, reducing antimicrobial use in agriculture by at least 30%. Involves cutting and eliminating it. The use of “medically important antimicrobials for human medicine” in farming where they are not needed to treat disease.

While “honored” to be part of the group, she said more formal structures are needed. “We need inter-country governance of climate change, somewhat like the COP,” Davis said.

Particularly important would be the establishment of an independent scientific panel similar to the IPCC, “otherwise, it's academics saying, 'Oh, we need this target.' have not taken on the journey, there is no reason why they would accept them – or should accept them.

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