Author: Sara Habibipour
Antibiotic resistance is one of the world’s most pressing issues in public health.
In the United States alone, more than 2.8 million antimicrobial infections occur each year. Bacteria are living creatures that evolve and adapt to physical threats, such as antibiotics. As antibiotics are overprescribed and taken incorrectly, the threat of bacterial and microbial resistance exponentially rises.
Without effective antibiotics, the world and modern medicine as we know it would shatter; organ transplants, routine surgeries, and chemotherapy would all be far too risky without antibiotics as a resource to control potentially fatal infections.
Take a look at the following graphic created by the CDC detailing several different microbes and which communities they disproportionaly impact:
Image Source: CDC
If this hasn't expressed to you how large of an issue antibiotic resistance is, then let me be clear: antibiotic resistance is far more than a medical problem. At its core, it is a global development issue.
Antibiotic resistance fuels poverty
Antibiotic resistance worsens the long-existing burden of infectious diseases in low and middle income countries. Second and third line antibiotics are oftentimes more expensive than first line alternatives, which means uninsured patients must pay significantly more to treat a resistant infection. Resistant infections also usually have a longer treatment period, requiring extensive hospitalization and time off of work, driving economically disadvantaged individuals further into poverty. Because of this, the World Bank reported in 2017 that antibiotic resistance can push 24 million people into extreme poverty by 2030.
Likewise, poverty fuels antibiotic resistance
There is a vicious circle that exists between poverty and infectious diseases, spun faster and faster by antibiotic resistance.
People living in poverty are more prone to infectious diseases. People who live in poverty are less able to prevent infectious diseases, especially when it comes to having sanitary toilets and hand-washing facilities. There are at least 2 billion people globally who use drinking water contaminated with feces. Situations such as these caused by poverty are what fuel the spread of microbes, including resistant ones.
Image Source: Re-Act
Universal access to healthcare is a necessity
Universal access to healthcare is a necessity in combating bacterial infections and resistant infections alike, but only if it is high quality healthcare. And, high quality healthcare cannot be delivered if we do not have a solution for antibiotic resistant infections such as MRSA and multi-drug resistant tuberculosis–diseases that disproportionately impact communities in poverty. Actually, there are some drugs that are effective in treating drug resistant tuberculosis, for example, but their costs lie within the several thousands, making them largely out of reach for underfunded TB programs, which is yet another issue related to pharmaceutical companies that I will likley write a separate article about. But, at the end of the day, universal health coverage that works to address the conditions that fuel antibiotic resistance, as well as the existing issue at hand, is the foundation for achieving health equity.
From an economic standpoint, if antimicrobial resistance is left unchecked, it could cause a global drop in GDP of up to 3.8% by 2050. The implications of antibiotic resistance are so much greater than an individual patient. They affect our global economy and the livelihood of every global citizen. It is not a problem of the future; action needs to be taken now.
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Sources:
If you’re interested in this topic, I recommend reading the following report: