Opinion: Bugs without boundaries

Published: 11-May-2015

Disease outbreaks such as Ebola tend to capture the headlines, while more insidious threats creep up on us unawares

It is only matter of months ago that the world was in a flat spin over the Ebola outbreak, throwing massive R&D efforts to develop treatments and vaccines and imposing draconian screening measures to prevent the disease spreading beyond the three countries affected. But there is another insidious, potentially even more serious threat on the horizon that is not – so far, at least – evoking a similar level of response.

In the run-up to its annual conference in April the European Society of Clinical Microbiology and Infectious Disease (ESCMID) warned that Europe could see more than a million deaths in total from antimicrobial resistance by 2025 in an impending ‘Antibiotic Armageddon’ unless more is done to develop new cures, rapid diagnostics and preventative measures to combat their spread.

So is this scaremongering or a realistic assessment? In truth, it seems that nobody really knows the extent of the problem. In 2009 European-wide deaths from antimicrobial resistance was estimated at 25–30,000 a year; 2013 figures will not be released until later this year – and even then are likely to be out of date.

ESCMID predicts that the mortality rate could exceed 50,000 per year in Europe within the next decade. Globally it could reach 10 million by 2050 – surpassing deaths from cancer, diabetes and road traffic accidents.

The lack of new antibiotics is not the only area for concern. ESCMID warns that Greece, Spain and Italy are facing an imminent crisis, as an increasing number of bacteria in these countries are now resistant to most, or all, forms of known antibiotics – a situation exacerbated, it says, by poor monitoring and control of the medicines supply chain and insufficient infection control in many healthcare institutions.

Bugs do not respect national boundaries and without a pan-European strategy it is only a matter of time before countries where the problem is currently less acute find themselves increasingly affected. The world should be taking this threat as seriously as it did that from Ebola not so very long ago.

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