Opinion: Why tackling the silent crisis of drug-resistant infections matters more than ever

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Testing for antimicrobial resistance. Photo by: Will Crowne / DFID / CC BY

The specter of an infectious disease pandemic killing tens of thousands of people across the globe is no longer a theoretical nightmare scenario. The World Health Organization’s “Disease X” is here, and despite consistent efforts by that agency and others to keep the political focus on this threat, the world has been caught largely unprepared.

If there is already a lesson to be learned from the COVID-19 pandemic, it is that too many political decisions are based on short-term thinking that ignores laws of nature. With our growing advances into the previously undisturbed natural world, viruses will continue to jump into human populations, causing devastating impacts.

Biology dictates how organisms evolve, particularly when we put pressure on them. With the large-scale and inappropriate use of antibiotics, bacterial infections will become increasingly drug-resistant. Importantly, this is also true for secondary infections associated with novel viruses.

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Countries responding to COVID-19 are benefiting from established tuberculosis programs worldwide, from diagnostics to contact tracing. But the patients meant to benefit from these TB tools and services face access barriers.

The link between COVID-19 and drug-resistant infections is more troubling than many realize. Antibiotics, while not effective against viruses, are being used frequently in people with COVID-19 to prevent or treat suspected or confirmed secondary bacterial infections. According to an early study from China, secondary infections causing bacterial pneumonia, bloodstream infections, sepsis, and hospital-acquired infections were present in half of all deceased COVID-19 patients.

Antibiotics are in high demand, and many of these infections are increasingly resistant to existing antibiotics. There are also growing concerns that the escalating use of antibiotics, coupled with disrupted supply chains, could lead to critical shortages of these key drugs within months.

There is another impact of COVID-19 that is less understood. As governments and health care infrastructures focus on the pandemic response, numerous research efforts to fight drug-resistant infections are slowing down or coming to a halt. This is compounded by the closure of laboratories and the inability of people to participate in clinical trials not related to COVID-19 — including those of new antibiotics.

In the medium and long terms, the economic shock resulting from the pandemic may mean that financial resources are diverted from critical health-system investments, including antimicrobial research and development. The consequence of this would be catastrophic — ranging from significant delays or even cancellations of critical research and development programs to the closure of research and biotech organizations working on diagnostics, vaccines, and treatments. Ultimately, it could mean the preventable loss of lives.

We must act now to prevent drug-resistant infections from becoming the next global public health emergency.

As a global health community, we must learn the lessons of COVID-19 and also take action to fight drug-resistant infections. COVID-19 caught us off guard, so we need to prepare for the next potential pandemic and drug-resistant infections.

Ensuring the effective use of antibiotics can save lives now and during future disease outbreaks. In terms of better understanding and addressing COVID-19 and bacterial infections, there are steps that can be taken by governments, policymakers, funders, and researchers, such as:

  1. Assessing how secondary bacterial infections, antibiotic use, and drug resistance affect the survival or death of COVID-19 patients.

  2. Protecting global access to and supply of critical antibiotics required by health care systems, especially while these systems are coming under intense pressure.

  3. Prioritizing the development of treatments to tackle drug-resistant infections. It is essential that such efforts are supported during this difficult period and accelerated once the pandemic subsides.

COVID-19 is a loud call for the entire global health community. There is a clear need to invest further in public health and health care systems, as well as collaborative research and development. Antibiotics, the backbone of our ability to respond to disease outbreaks, are also under threat. New, effective interventions are already needed now and this demand will increase.

The Global Antibiotic Research and Development Partnership, a not-for-profit organization that develops new treatments for drug-resistant infections, fosters partnerships between the private and public sectors and is positioned to accelerate the development of critically needed treatments that are accessible in a sustainable and responsible manner.

Just like COVID-19, antibiotic resistance is a health security crisis that moves silently within populations and knows no boundaries. No single country, company, or organization can fight drug resistance alone; it can only be done in partnership.

We must act now to prevent drug-resistant infections from becoming the next global public health emergency. Governments must take steps to accelerate the introduction of necessary interventions, including the development of new treatments for bacterial infections.

The views in this opinion piece do not necessarily reflect Devex's editorial views.

About the author

  • Manica Balasegaram

    Dr. Manica Balasegaram is a British medical doctor and currently executive director of the Global Antibiotic Research and Development Partnership in Geneva.