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Antibiotic-resistant infections could cause more than 39 million deaths across the world between now and 2050, according to a study published in The Lancet.
The findings, published on 16 September 2024, suggest that deaths from antimicrobial resistance (AMR) will rise by almost 70% in 2050 compared with 2022, with people aged over 70 years the worst affected.
Between 2025 and 2050, the researchers estimate that AMR will lead directly to a total of more than 39 million deaths in all ages and will be associated with 169 million deaths.
The study by the ‘Global Research on Antimicrobial Resistance’ (GRAM) project also looked at global trends in AMR between 1990 and 2021, and found that more than 1 million people on average died each year as a result of AMR.
Data also show that AMR deaths among children aged under 5 years declined by 60% between 1990 and 2021, from 488,000 deaths in 1990 to 193,000 deaths in 2021. The authors attributed this to major improvements in infection prevention control measures, such as vaccination programmes.
However, deaths directly linked to AMR in people aged 70 years and older increased by 90% from 1990 to 2021, the research found. The authors said these trends are expected to continue in the coming decades.
The data analysis was based on 520 million records — including hospital data, death records and antibiotic use data — from 204 countries to produce estimates for 22 pathogens, 84 pathogen-drug combinations and 11 infectious syndromes, such as meningitis and bloodstream infections.
The researchers used statistical modelling to produce the estimates of deaths from AMR and those in which AMR played a role, with the period of 2022 until 2050 estimated to contain the most likely global and regional health impacts of AMR.
They noted that AMR deaths were lower in 2021 compared with 2019 — 1.14 million direct deaths and 4.71 million associated deaths, versus 1.27 million direct deaths and 4.95 million associated deaths — which they attributed to social distancing and other disease control measures put in place during the COVID-19 pandemic.
The research follows another study by ‘GRAM’, published in The Lancet in 2022, results of which found that global AMR-related deaths in 2019 were higher than those from HIV/AIDS or malaria, leading directly to 1.2 million deaths and contributing to a further 4.95 million deaths.
Stein Emil Vollset affiliate professor at the Institute For Health Metrics and Evaluation at the University of Washington School of Medicine, a study author of the analysis, said: “There has been real progress in tackling AMR, particularly among young children, but our findings indicate more must be done to protect people from this growing global health threat.
“By 2050, resistant infections could be involved in some 8 million deaths each year, either as the direct cause of death or as a contributing factor. 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.”
Colin Brown, deputy director at the UK Health Security Agency responsible for AMR, commented: “This report is another reminder that antibiotic resistance is a threat to all of us — not just in the future but now. If more infections continue to become resistant to treatment, lives will continue to be lost and we need universal action to turn this tide.
“We’re working with partners to ensure the efficacy of antimicrobials now and for future generations using our expertise and capabilities. We have cutting-edge surveillance and modelling, ongoing research to inform prescribing practices, and are continually testing different therapeutic and diagnostic approaches to treat multidrug resistant organisms.
“We are also working to optimise the use of existing antimicrobials and discover new ways to stop infections occurring in the first place.”
In August 2024, NHS England invited expressions of interest from pharmaceutical companies for the provision of antimicrobial products via a subscription payment model.
The model, first announced in 2019, incorporates a subscription-type fixed-fee contract value with a performance component, where payment is not linked to the volume of antimicrobials supplied, but rather on the supplier satisfying specified performance requirements, such as surety of supply, stewardship and surveillance, in a bid to tackle AMR.
