Superbugs will kill more than 39 million people before 2050, with older people especially at risk, according to a new global analysis.
While deaths related to drug resistance are declining among very young children, driven by improvements in vaccination and hygiene, the study found the opposite trend for their grandparents.
By mid-century, it is predicted that 1.91 million people per year will die directly worldwide as a result of antimicrobial resistance (AMR) – in which bacteria evolve so that the drugs usually used to fight them no longer work – from 1.14 million in 2021. AMR will play a role in 8.2 million deaths annually, up from 4, 71 million.
The study, published in the Lancet was carried out by the Global research on antimicrobial resistance (Gram) Project and is the first global analysis of AMR trends over time.
Researchers used data from 204 countries and territories to make estimates of deaths from 1990 to 2021, and projections running to 2050.
They also found that millions of deaths worldwide could be prevented through better prevention of infections and improved access to health care, as well as the creation of new antibiotics.
The study’s author, Dr. Mohsen Naghavi, at the University of Washington’s Institute of Health Metrics (IHME), said: “Antimicrobial medicines are one of the cornerstones of modern healthcare, and increasing resistance to them is a major cause for concern.
“These findings highlight that AMR has been a significant global health threat for decades and that this threat is increasing,” he said.
World leaders will meet in New York this month to discuss antimicrobial resistance at the UN General Assembly. They are expected to reaffirm a political statement on stepping up action against antimicrobial resistance, which campaigners hope will include a target to reduce AMR deaths by 10% by 2030.
The study, which involved more than 500 researchers from institutions around the world, found a “remarkable” decline in AMR deaths among children under 5 – from 488,000 to 193,000 – between 1990 and 2022. They will again 2050 halve.
Although deaths from infection in young children are fewer in number, they are increasingly caused by drug-resistant bacteria.
And death tolls are rising in all other age groups, with AMR deaths among the over-70s already up 80% in three decades and expected to rise 146% by 2050, from 512,353 to 1.3 million.
Dr Tomislav Meštrović, assistant professor at University North in Croatia and an affiliated associate professor at the IHME, said the trend reflects rapidly aging populations, with older people more vulnerable to infection.
“About three-quarters of AMR infections are linked – for example to hospital infections – and a rapidly aging population also requires more hospital care,” he said. Older people have more chronic diseases such as diabetes and heart disease.
“For example, you insert an IV [intravenous] line, it gets infected, you get bacteria in the blood, those bacteria are likely to be more resistant,” he said.
Vaccination was often less effective in older people because the immune system worsened with age, he added, and older people were more likely to have reactions to antibiotics.
AMR deaths in 2021 were lower than in 2019, but the researchers said this was likely to be only a temporary reduction due to fewer infections due to Covid-19 control measures.
The study projected that the highest numbers of future deaths would occur in South Asian countries such as India, Pakistan and Bangladesh, as well as other parts of southern and eastern Asia and sub-Saharan Africa.
They are one of the areas that have already seen the highest growth in AMR, and could also see some of the biggest benefits from improving overall infection care and expanding access to antibiotics.
