Antimicrobials – antibiotics, antivirals, antifungals and antiparasitics – are substances widely used to prevent and treat infections in humans, aquaculture, livestock and crop production. Their effectiveness is now in jeopardy because a number of antimicrobial treatments that once worked no longer do so because microorganisms have become resistant to them. Microorganisms that develop resistance to commonly used antimicrobials are referred to as superbugs. UNEP released in 2023 the flagship report Bracing for Superbugs: Strengthening environmental action in the ‘One Health’ response to antimicrobial resistance

 What is antimicrobial resistance (AMR)?  

AMR occurs when microorganisms such as bacteria, viruses, parasites or fungi become resistant to antimicrobial treatments to which they were previously susceptible. 

Increased use and misuse of antimicrobials and other microbial stressors, such as pollution, create favourable conditions for microorganisms to develop resistance both in humans and the environment. Bacteria in water, soil and air, for example, can acquire resistance following contact with resistant microorganisms. Human exposure to AMR in the environment can occur through contact with polluted waters, contaminated food, inhalation of fungal spores, and other pathways that contain antimicrobial resistant microorganisms.  

What is the impact of AMR?  

The World Health Organization (WHO) lists AMR among the top 10 threats for global health. 

Antimicrobial resistance threatens human and animal health and welfare, the environment, food and nutrition security and safety, economic development and equity within societies. 

Predicted mortality from AMR compared to common causes of death today
Predicted mortality from AMR compared to common causes of death today (adapted from O’Neill 2016; Murray et al. 2022)  

AMR ranks among the leading causes of mortality, New estimates reveal that 39 million deaths directly attributable to bacterial AMR will occur between 2025-2050 – which equates to three deaths every minute - and 169 million deaths associated with bacterial AMR (Source).

If unchecked, AMR could shave US $3.4 trillion off GDP annually and push 24 million more people into extreme poverty in the next decade. 
 
Antimicrobial resistance in mycobacterium tuberculosis, malaria parasites, viruses and HIV is becoming a reality that could increase human suffering. It could also deal a huge blow to the world economy, due to productivity losses, increased healthcare costs and a rise in poverty. Even if it is a global crisis, poverty, lack of sanitation and poor hygiene make AMR worse. Also, AMR disproportionately impacts Low-Income Countries and Lower-Middle-Income Countries. AMR is thus an equity issue too.