Over 39M people could die from superbugs by 2050

More than 39 million people worldwide could die from antibiotic-resistant infections from 2025 to 2050 as the superbug crisis intensifies, according to a new global analysis of antimicrobial resistance.

By 2050, annual death tolls attributed to or associated with antibiotic resistance will reach 1.91 million and 8.22 million, respectively, if remediation measures are not put in place. [Lancet 2024;404(10459):1199-1226]

“Those numbers represent increases of nearly 68 percent and 75 percent per year, respectively, compared with death tolls attributed to antibiotic resistance in 2022,” said researchers who conducted the study. “Older people are most at risk, roughly driving the increase in fatalities.”

They forecasted the increase in death tolls would strain health systems and national economies and contribute to annual gross domestic product losses of $1 trillion to $3.4 trillion by 2030.

Resistant microbes

Antimicrobial resistance (AMR) occurs when pathogens like bacteria, fungi, and parasites evolve and no longer respond to medications that kill them, making infections more challenging to treat.

“It’s a big problem that is here to stay,” said senior author of the study, Dr Christopher Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington in Seattle, Washington, US.

The study, conducted as part of the Global Research on Antimicrobial Resistance Project, involved 500 researchers and is the first to analyse global AMR trends over time. Estimates were made for 22 types of disease-causing organisms, 84 combinations of drugs vs bacteria, and 11 infectious syndromes such as meningitis and sepsis.

About 520 million datasets were examined, including hospital discharge records, insurance claims, and death certificates from 204 countries and territories. Using statistical modeling, they found that more than 1 million deaths related to AMR occurred each year from 1990 to 2021.  Forecasts are running through 2050.

3 deaths every minute

Professor Kevin Ikuta, lead author of the study and clinical infectious diseases physician at the University of California Los Angeles in California, US, said the projected 39 million deaths equate to about three per minute. An estimated 11.8 million deaths will be in South Asia. Deaths from AMR will also be high in eastern Asia and sub-Saharan Africa.

“Between 1990 and 2021, children ≤5 years saw a more than 50 percent decrease in AMR deaths, whereas seniors aged ≥70 saw an increase of more than 80 percent,” he shared. “Deaths among children will continue to decline, halving by 2050, but deaths will double among seniors over the same period.”

As the global population ages, AMR deaths among seniors may soon outpace those in other age groups, Ikuta warned.

“Increasingly, we’re seeing that antibiotics are being overused or misused, which puts more pressure on bacteria to become more resistant with time,” he added.

In one study, for example, 1 in 4 hospitalized children in the US was prescribed antibiotics suboptimally. Reasons for inappropriate use included a bug-drug mismatch, surgical prophylaxis, overly broad empiric therapy, and unnecessary treatment.  [Clin Infect Dis 2020;71:e226-e234]

The WHO said AMR makes common infections harder to treat and medical interventions, such as chemotherapy and caesarean sections, riskier.

Hence, the researchers advocate for better access to healthcare, new vaccines and antibiotics, and judicious antibiotic use protocols to stem the tide of AMR and save lives globally.

Murray said fighting AMR will require teamwork. “We can’t do this on a piecemeal. We need a concerted global effort.”