Every year, approximately 750,000 deaths attributed to drug-resistant superbugs could be avoided if there was better access to clean water and sanitation, infection control, and childhood vaccinations, according to research findings. The rise of antimicrobial resistance (AMR) poses a significant global challenge, with drug-resistant superbugs evolving due to factors such as inappropriate and excessive antibiotic use. This alarming trend raises concerns about the future efficacy of modern medicine.

Experts warn that if urgent action is not taken to address AMR, the death toll will steadily increase, particularly impacting vulnerable groups such as infants, elderly individuals, and those with chronic illnesses or in need of surgical procedures. Professor Ramanan Laxminarayan from Princeton University emphasizes that AMR currently claims more lives than HIV, malaria, and tuberculosis combined. He stresses that tackling AMR is crucial not only for newborn survival but also for healthy aging.

The data for 2019 revealed an estimated 4.95 million deaths associated with bacterial AMR, including 1.27 million directly caused by resistance. Low- and middle-income countries (LMICs) bear the brunt of the AMR crisis, prompting calls for targeted interventions in such regions. Models created by Laxminarayan and colleagues suggest that three key steps could reduce AMR-related deaths in LMICs by 18%, equivalent to approximately 750,000 lives saved annually.

The first step involves universal access to clean water, improved sanitation, and hygiene, which could prevent an estimated 247,800 deaths. Additionally, better infection prevention and control in healthcare settings could prevent 337,000 deaths, while childhood vaccinations could prevent a further 181,500 deaths. Improved vaccination strategies not only prevent infections resistant to current drugs but also curtail the inappropriate use of antibiotics.

Furthermore, the use of vaccines against four key bacterial infections could directly prevent 95,400 deaths of children under the age of 15 each year. However, it is emphasized that vaccinations against viral infections also play a crucial role. Influenza, in particular, drives a significant portion of antibiotic consumption worldwide, as people often cannot distinguish between viral and bacterial infections and opt for broad-spectrum antibiotics as a precautionary measure, leading to drug resistance.

The study, published in The Lancet, is part of a series on AMR and introduces the "10-20-30 by 2030" goals. These targets aim to reduce mortality from AMR by 10% relative to 2019, decrease inappropriate human antibiotic use by 20%, and lower inappropriate animal antibiotic use by 30%. While ambitious, experts believe these goals are feasible, citing the decline in animal antibiotic use since 2019.

The research highlights the need for improved access to antibiotics, diagnostic tests, and vaccines. The establishment of an independent panel on antimicrobial access and resistance, similar to the Intergovernmental Panel on Climate Change (IPCC), is also proposed to gather evidence on AMR and develop informed guidelines. The researchers stress the urgency of addressing AMR, as the window of opportunity to effectively treat bacterial pathogens is shrinking.

Professor Ben Cooper from the University of Oxford, who was not involved in the research, commends the careful and thorough analysis supporting the estimate of 750,000 preventable deaths. He highlights the importance of addressing the chronic global underinvestment in combating AMR to achieve these reductions. Dr. Danna Gifford from the University of Manchester acknowledges the challenges ahead and emphasizes the need for sustained commitment and global collaboration to meet the proposed targets. She emphasizes that preventive measures are key to reducing the global burden of resistance, rather than relying solely on the development of new antimicrobials.