NEW YORK • For decades, public health experts have warned of the dangers of "superbugs", microbes that cannot be stopped with drugs.
Now, for the first time, world leaders are tackling the problem at a high-level United Nations (UN) summit in New York.
Yesterday's meeting underscored the growing awareness by governments and disease experts that drug resistance is not just a health problem but an enormous economic and security threat as well. It is also a global threat, because drug resistance spreads easily across species and worldwide. This is only the fourth time the world's decision makers have addressed a health issue at the UN General Assembly.
"There's a recognition now by different people, different sectors and different organisations that we are, in fact, dealing with an enormous challenge beyond a health issue alone," said Dr Keiji Fukuda, who oversees antimicrobial resistance at the World Health Organisation (WHO). "It doesn't happen very often for health issues."
On Monday, the World Bank said drug-resistant infections could cause global economic damage comparable to the 2008 financial crisis. In a worst-case scenario, it projected that low-income countries could lose more than 5 per cent of their gross domestic product and that up to 28 million people, mostly in developing countries, could be pushed into poverty by 2050.
Without changes in policies to combat drug resistance, an estimated US$100 trillion (S$136 trillion) in economic output could be put at risk by 2050, according to a separate analysis by an independent British commission chaired by former Goldman Sachs chief economist Jim O'Neill.
Antimicrobial resistance refers to infections that have evolved the ability to withstand drugs that ought to stop them. The medicines include antibiotics, which act on bacteria, as well as drugs to fight fungal, viral or parasitic infections. If these medicines are rendered ineffective by multidrug-resistant superbugs, even the most minor infections would be untreatable, bringing back a level of danger not seen since the 19th century.
About 700,000 people die every year from drug-resistant infections, according to WHO. Without policies to halt the spread of this resistance, the toll could soar to 10 million deaths annually by 2050, or one person every three seconds, according to the British commission review. That is more than the number of deaths each year from cancer.
At the summit, leaders are expected to issue a call to action to reduce inappropriate use of antimicrobial medicines in humans, restrict the routine use of antibiotics to boost growth in farm animals, improve access to better diagnostics, and jumpstart new drug development.
In the United States, for example, nearly a third of antibiotics prescribed are not needed and not effective, according to a recent study.
The widespread use of antibiotics in animals encourages development of resistant microbes that can spread to humans and then withstand drug treatments.
"If you want to solve these problems, you need targets and a kind of accountability mechanism to make sure countries do what they say," said Dr Ramanan Laxminarayan, an infectious disease researcher who directs the Centre for Disease Dynamics, Economics & Policy.
The draft resolution being considered at the United Nations this week does not include such specifics, a weakness that Dr Laxminarayan called "disappointing". Still, he and other experts said they are encouraged that the issue is getting high-level attention.
Meanwhile, superbug outbreaks are spreading. The newest superbug, resistant to an antibiotic called colistin, has been detected in nearly 30 countries since its discovery was reported in China a year ago. Colistin is known as the antibiotic of last resort because many infections that are resistant to every other drug do still respond to colistin.
The gene for colistin resistance has been found in at least four people in the US. The worst-case scenario would be if the gene jumps into other bacteria that can already evade most antibiotics, creating a kind of uber-superbug.
Experts say the biggest challenge will be to raise awareness and spur action from governments down to individuals. But many people do not think their individual actions are adding to the problem. "If you talk to any individual physician, they all agree drug resistance is a big problem," said Dr Laxminarayan. "But they are not the ones who overprescribe."