A DEVELOPING CRISIS

Most big pharmaceutical companies have all but quit research and development of new antibiotics since it is a low-return venture. Rapid rise of antimicrobial resistance means the old ammunition is misfiring. Without effective antibiotics, global healthcare will lose the treatment framework it stands on. A report by AMIT KHURANA, RAJESHWARI SINHA and GAURI ARORA on the precipitating global health crisis

- AMIT KHURANA, RAJESHWARI SINHA and GAURI ARORA

I WOULD PRAY very hard," says V Ramasubramanian, when asked what if antibiotics failed to work one day. For the Chennai-based doctor who specialises in infectious diseases and tropical medicines, it is just impossible to contemplate a world without these wonder drugs that have revolutionised modern medicine since Alexander Fleming discovered the first of the kind, penicillin, in 1928. Today, antibiotics underpin much of the treatment we receive-be it for a small scrape or an organ transplant. Scientists estimate that by preventing people from dying of bacterial infections, antibiotics have helped increase life expectancy by 23 years. But the progress made over the last century is getting eroded.

Repeated exposure to antibiotics, due to unnecessary use, has prompted these single-cell pathogens to mutate and evolve their defence mechanisms to inactivate or evade the drugs. A May 2023 study by UK researchers has found that some bacteria adapt special pumps to flush antibiotics out of their cells. Then there are those resistant to multiple drugs. Last year, a report by medical journal The Lancet found that antibiotic resistance is now a leading cause of death worldwide. In 2019, antibiotic resistance was linked to 5 million deaths, with 1.3 million deaths directly attributed to it.

The real danger is that while bacteria are developing drug resistance at a disconcerting pace, not many antibiotics are in sight to replace the failing ammunitions. "We see bacteria that are resistant to almost all currently available antibiotics," Giorgia Sulis, assistant professor, School of Epidemiology and Public Health, University of Ottawa, Canada, who has worked extensively on tuberculosis (TB), tells