On January 19, The Lancet published the paper ‘Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis’. This paper provided evidence that in 2019 antibiotic-resistant infections were the third leading cause of deaths worldwide, overtaking malaria deaths and human immunodeficiency virus (HIV) deaths.

Without effective antibiotics, common infections, such as pneumonia, tuberculosis, gonorrhoea and salmonellosis, will not be able to be effectively treated. The inability to prevent infections will seriously limit the ability to carry out routine surgeries and procedures, such as chemotherapy.

Antibiotic resistance has long been recognised as a threat to health. Yet despite the exponential rise in antibiotic-resistant bacteria, little has been done to address it. There is a ‘discovery void’ of antibiotics, where no new antibiotic class has been discovered and developed since 1987. Antibiotics are being used en masse more than ever. A 2017 study by Klein and colleagues, published in PNAS, shows that between 2000 and 2015 the global rate of antibiotic consumption increased by 65%. Of particular concern was the rapid increase in the use of last-resort antibiotics. Many studies point to the agriculture industry as one of the largest consumers of antibiotics, as antibiotics are used to prevent infection breakouts in intense farming practices and increase growth rate and weight gain amongst livestock.

Previous studies estimated that antibiotic-resistant infection deaths will reach 10 million by 2050. However, Murray and colleagues’ study demonstrated that this estimate is far closer than previously expected.

Governments need to address this global health threat now in order to keep antibiotics effective. Many lessons can be learned from the CoviC-19 pandemic that can be applied in this situation. Antibiotic regulations need to be put into place immediately, limiting use in agriculture and banning over-the-counter use. Clear public health messaging needs to be implemented to help the public understand the threat and learn what they can do to prevent it. Serious public and private investment need to be put into discovering new antibiotics and bringing them to market rapidly, leveraging the fast-tracking system used for Covid-19 vaccines and drugs.