Scientists warn STIs could be deadly by 2040: What is AMR and how does it threaten our health?
'We can't let antibiotics stop working – not in our lifetime'
In the near future, the everyday life we take for granted could be deadly, scientists have warned.
Some 1.2 million people currently die from drug-resistant infections each year, and by 2040, this could be catastrophic as resistance to antibiotics increases.
Common sexually transmitted infections (STIs), for example, are already being affected by this, with rates of gonorrhoea increasing by more than 50% since 2021, and at risk of becoming a widespread fatal illness by the predicted date.
This ticking time bomb is all down to antimicrobial resistance (AMR), which could kill 10 million people globally every year by 2050 if the government doesn't invest in funding for new antibiotics now, something leading experts at the Ineos Oxford Institute for Antimicrobial Research (IOI) are pleading for.
But what is AMR, how does it threaten our health, and what can we do about it?
What is AMR?
AMR has been described as one of the biggest public health threats facing the world today. Concerning, but there's still time to turn things around.
AMR occurs when microbes (bacteria, viruses, fungi) develop the ability to resist the action of antibiotics that would otherwise kill them off or prevent them from growing. So we're not resistant to drugs, the bacteria that causes our infection is.
The emergence of AMR is accelerated by the overuse and misuse of antibiotics in humans and animals, as well as lack of research and innovation to develop new antibiotics.
How does AMR threaten our health?
So, what can AMR affect? "Just about everything," Professor Timothy Walsh, research director at the IOI, tells Yahoo Life UK.
Gonorrhoea – the second most common bacterial STI in the UK – is already causing fatalities in the UK and is at risk of becoming increasingly untreatable due to the rapid rise of AMR.
But it's not just common STIs we need to think about. Some 92% of bacteria that cause urinary tract infections (UTIs) are resistant to at least one common antibiotic, and 80% are resistant to two. So, for example, you might contract cystitis caused by E. Coli, which can be very resistant to antibiotics.
Other than things like sex, many more activities we take for granted could become highly dangerous due to AMR. Sport-related injuries, ear infections, burns, and scrapes could become harder to treat. "Common medical procedures such as C-sections or hip replacement surgery could carry high risks," says Prof Walsh.
"Due to a lack of investment in research, we haven’t discovered a new class of antibiotics for almost 40 years. Without the development of new solutions to combat the rise of bacterial resistance to current antibiotics, we will inevitably return to a pre-antibiotic era," he adds.
How can we prevent or fight AMR?
1. Hygiene
For the UK, Prof Walsh urges, "Try and mitigate transmission of bacteria [that may be resistant to antibiotics] with personal hygiene."
"Wash your hands after you've gone to the toilet or used public transport. It's the simple things like alcohol scrubs, washers, and hand rubs."
While in 2020 in the height of COVID, everybody was masked up and washing their hands, now on any given night out, for example, you probably won't find anyone doing this, with everyone hugging freely.
"It's interesting how as creatures of habit we have decided to revert back and forget everything," Prof Walsh observes. However, he adds, "That's not to say we need to be paranoid about AMR. We have more bugs in us and on us than we do in human cells. We are more bacteria than we are human, in terms of cell numbers.
"Bacteria can be friendly. And guess what, they help protect you as well from infection from nasty bacteria. So the messaging here isn't 'they're all evil and we need to be super sterile'. It's about just simply having some common sense with hygiene."
Walsh also believes we need to improve the way in which the UK manages sewage and potable water.
2. Correct use of antibiotics
Do we use antibiotics too much and inappropriately?
"In the UK, I think we're really very good. Hopefully, your GP will know better when to administer an antibiotic and when not to. Knowing what I know, trying to get antibiotics out of my GP is like trying to get blood out of a stone," says Prof Walsh.
Of course, not all of us have expertise in AMR and a lot of us want quick fixes (which can cause longer-term problems). "The vast majority of antibiotics are used in the community when people go to their doctor," he acknowledges. "And depending on who your GP is, who you are, and how persuasive you are, you may get ciprofloxacin, for example. And that is a bit of a nightmare antibiotic if it's not needed."
Prof Walsh also observes how things have been "slightly complex and muddled" since COVID, leading to more remote appointments and less thorough physical examinations.
In terms of what we can do, remember antibiotics don't help viruses, and if your doctor prescribes antibiotics but says 'only take them if you haven't got better in a week', it's probably worth listening. Always finish a course of antibiotics if prescribed (unless told otherwise), never save them for another time, and definitely don't hand them out to a friend.
Antibiotics are lifesaving drugs and should be taken promptly when needed, so it's a case-by-case basis. "The fact of the matter is more people die through lack of access to appropriate antibiotics, than due to antimicrobial resistance," Prof Walsh adds.
3. Testing
In the UK, we're fortunate in that we can efficiently and quickly test for things like STIs, to determine the best course of treatment.
"And we're now getting to the point where we can have diagnostic kits that will tell whether something is viral or bacterial. Hopefully, these will be available around the world in general practice in the not too distant future too," says Walsh.
4. Good messaging
Prof Walsh urges that the UK's messaging to the rest of the world shouldn't be 'we've already done this and we're the good guys', as looking at climate change, this hasn't really helped.
"We're trying to make sure that when we speak to other countries, we're trying to understand what their needs are and what their direction of travel is in the next couple of years. We want to avoid any colonialist messaging. There are different concerns for different people in different countries."
And globally speaking, it's about being aware that "the planet is a very small place", circling back to hygiene. A bacteria weighs just five picograms, so you can only imagine how easy it is to spread when the wind blows, or in farms, sewage, and the community. "We're all connected with this in terms of a global concern."
5. Investment
There has been a lack of investment in antibiotics partly due to profitability, but prof Walsh urges this is something we need to change the model on.
"It's like investing in a fire extinguisher. You aren't going to use that fire extinguisher for 364 days of the year. But when you want to use it, it will save loads of lives. But that's not going to make your money," he explains. "So investment into research into new and novel antibiotics is great. But then we have to look at the pipeline, and make sure that the companies who commit to this, are rewarded."
And of course, while we need new antibiotics for now, we will one day need a longer-term solution.
Does eating meat increase our chances of AMR?
Should we stop eating meat to avoid more antibiotic consumption? "The argument is really more of a moral one, not a personal health one," says Walsh. "If you go to a restaurant and you eat chicken, and it's been fed on antibiotics, due to what we call washout, there won't be any actually left in the meat, almost 0.
"Then the question is, if the chicken on the farm was given antibiotics, does the chicken actually have bacteria on it that are resistant to those antibiotics? The answer would be almost certainly yes. Then as part of the processing, is that meat going to be contaminated with those bacteria? The answer is probably yes. But then when you cook the chicken, are you going to kill those bacteria? And the answer is almost certainly, yes.
"You could say, does becoming a vegetarian or vegan solve the problem? The answer is no...because we still use antibiotics on crops." There are of course other benefits to eating less meat on your health and the planet.
While Walsh explains that in the UK we have cut down on antibiotics in farming – used to make animals grow faster and heavier and more profitable – they're still used on a mass scale around the world. That's why scientists at Oxford are working to develop new molecules that aren't antibiotics but have the same effect, to safeguard human antibiotics.
Get involved with the #NotInOurLifetime campaign and sign the petition for increased AMR funding here.
If you experience any signs of infection or illness, consult your doctor for advice as soon as possible.
Read more: What is sepsis? Strictly's Amy Dowden recalls near-death experience while undergoing chemo (Yahoo Life UK, 5-min read)
Read more: 'Hidden’ bacteria could explain chronic urinary tract infections (Yahoo Life UK, 2-min read)
Read more: Non-genital STIs: All the areas of your body they can affect and how to prevent them (Yahoo Life UK, 4-min read)
Watch: 'I thought I could cure my UTI with cranberry juice until it gave me sepsis'