Antimicrobial resistance is a large and growing problem, with the potential for enormous health and economic consequences for the United States and the rest of the world. According to a new OECD report, released Wednesday, superbug infections could cost the lives of about 2.4 million people in North America, Europe and Australia over the next 30 years unless more is done to stem antibiotic resistance.
On average, about 29,500 persons die each year in the United States from infections related to eight resistant bacteria. By 2050 it is estimated that antimicrobial resistance will kill about 1 million people in the United States.
The economic toll of this superbug crisis is huge: In the United States alone the health-care costs dealing with antimicrobial resistance could reach $65 billion by 2050, according to the OECD report. That is more than the flu, HIV and tuberculosis. If projections are correct, resistance to backup antibiotics will be 70 percent higher in 2030 compared to 2005 in OECD countries. In the same period, resistance to third-line treatments will double across EU countries.
The bottom line: Between 2015 and 2050, antimicrobial resistance would cost about $3.5 billion per year to the health-care services of the 33 countries included in the analysis. The impact on quality of life, measured through disability-adjusted life years, will be even larger, with up to 1 out of every 232 individuals losing one year of life in good health because of antimicrobial resistance in the OECD countries.
Earlier this year, the U.S. Centers for Disease Control and Prevention warned it had detected 221 strains of a rare breed of "nightmare bacteria." This bacteria is virtually untreatable by antibiotics and have special genes that enable them to spread their resistance to other germs. Nightmare bacteria is particularly deadly in the elderly and people with chronic illnesses. The probability of developing a resistant infection is also significantly higher for children up to 12 months of age, and men are also more likely to develop resistant infections than women. Nearly half of the resulting infections prove fatal.
A five-pronged assault on antimicrobial resistance
There are ways countries can tackle the problem. A short-term investment to stem the superbug tide would save lives and money in the long run. Just a couple of dollars a year per person would be enough to prevent three quarters of the projected deaths due to superbugs, predicts the OECD. Three out of four deaths could be averted by spending just $2 per person a year on measures as simple as handwashing and more prudent prescription of antibiotics.
"Investing $2 per person per year in a comprehensive package encompassing public health measures would avoid about 47,000 deaths per year in OECD countries," says Michele Cecchini, senior health economist and policy analyst at the OECD'S health division. "The public health package could pay for itself within just one year and end up by saving $4.8 billion of dollars per year in OECD countries."
A five-pronged assault on antimicrobial resistance — promoting better hygiene and sanitation among health-care workers; ending the overprescription of antibiotics; testing patients more quickly to determine whether they have viral or bacterial infections; delaying antibiotic prescriptions by three days, and creating more public awareness campaigns — could counter one of the biggest threats to modern medicine.
"Investing $2 per person per year in a comprehensive package encompassing public health measures would avoid about 47,000 deaths per year in OECD countries."
Perhaps just as important was the additional call for a "One Health" approach, which acknowledges that human health is tied to that of animals, both on farms and in the wild, and that complete health care must address animals alongside humans.
Investment in a comprehensive public health package encompassing some of these measures in OECD countries could pay for themselves within just one year and end up saving $4.8 billion per year, says the OECD.
Meanwhile, resistance for the eight antibiotic-bacterium in the United States has increased from 20 percent in 2005 to 23 percent in 2015 and is poised to hit 25 percent by 2030.
"The U.S. can do better," Cecchini says. "The absence of a national health-care system makes coordination more difficult." As he explained: A more prudent prescription of antibiotics is needed. A package combining stewardship programs, enhanced environmental hygiene, mass media campaigns, and rapid diagnostic testing would cost to the U.S. a total of $4.93 per capita per year. This package would avert 20,000 deaths and save $2.8 billion per year in the U.S.
A global crisis
The superbug crisis is projected to grow even more rapidly in southern Europe, including Italy, Greece and Portugal. Low- and middle-income countries, such as Brazil, Indonesia and Russia, will also be hit hard, according to OECD projections.
The average resistance proportions in Turkey, Korea and Greece (about 35 percent) were seven times higher than in Iceland, Netherlands and Norway, the countries with the lowest proportions (about 5 percent).
Resistance is already high and projected to grow even more rapidly in low- and middle-income countries. In Brazil, Indonesia and Russia, for example, between 40 percent and 60 percent of infections are already resistant, compared to an average of 17 percent in OECD countries. In these countries, growth of antimicrobial resistance rates is forecast to be 4 to 7 times higher than in OECD countries between now and 2050.
— By Nasos Koukakis, special to CNBC.com