The Guardian view on antimicrobial resistance: we must prioritise this global health threat | Editorial

Aand apocalyptic horror stories are up there with the scariest. Yet not science fiction writers, but leading scientists are warning what the world could look like after superbugs develop resistance to the remaining drugs against them in our hospital pharmacies. Patients who can currently be cured will die; routine surgery will become dangerous or impossible. Antimicrobial resistance (AMR) – occurring not only with bacteria but also with viruses, fungi and parasites – is one of the greatest global public health threats facing humanity, says the World Health Organization (WHO). It kills 1.3 million people and contributes to 5 million deaths each year, expected to be 10 million by 2050. In addition to the horrific human toll, this will increase the strain and cost of health services. But is it high enough on the agenda? Covid-19 has removed it and the climate crisis is getting more attention. AMR doesn’t get top billing that often.

Efforts were made this week to change that, with talks at the UN triggering wider coverage detailing the sorry state we find ourselves in. From the pharmaceutical industry to the WHO to NHS England, the same tune is being played: we are not doing enough to prevent disaster.

Ms Sally Davies, former Chief Medical Officer for England and now UK Special Envoy on AMR, told the Guardian this resistance can make the Covid pandemic “seem insignificant”. Tragically, her godson, a double lung transplant recipient for cystic fibrosis, died at age 38 from an antibiotic-resistant infection. Low- and middle-income countries will be hardest hit. But those who think this is a developing world problem should think again.

This is a multifaceted question. There is no quick fix. Antibiotics are still used too widely and incorrectly. They do not work against viruses that cause coughs and if you are prescribed it is vital that you complete the course or a resistant strain of bacteria may develop. Staggering amounts—two-thirds of all antibiotics—are used in agriculture, to keep animals healthy. While those responsible must play their part, it is clear that concerted intergovernmental action is needed on all fronts.

We should value the antibiotics we have by using them sparingly. And we badly need more. Only 10 new antibiotics were approved between 2017 and 2023. according to the international pharmaceutical trade organization, only two of which are considered innovative by the WHO and neither is a new class of antibiotic. In January, American scientists announced that they had discovered a molecule that works in a new way against one of three highly drug-resistant bacteria considered the biggest threat to human health – but so far the drug has only been tested in mice.

Hopefully it will go further, but companies are in business to make money. New antibiotics are stockpiled for the day when the old ones don’t work. So there is no profitable market. Economist Jim O’Neill offered a prize fund to pay pharmaceutical companies to develop new antibiotics. The NHS is piloting the very thing, awarding two companies with lump sums of £10m per year instead of paying for ordered packs of pills. Other countries, including Japan and the US, are exploring the idea. More need to join in and pull pharmaceuticals in the direction we need.

This week’s flurry of interest is a prelude to a UN General Assembly meeting on AMR in September, which aims to persuade governments around the world to do more. Whatever else may happen in the meantime – from wars to pandemics – nothing should be allowed to distract them from engaging with a new and determined focus on one of the most critical issues of our time.