Issue No. 17: Unsettling Trends in the Fight Against Superbugs

The COVID-19 pandemic felt like it arrived swiftly, spreading around the world in a matter of weeks. By contrast, another public health crisis has been years in the making.
Over decades, our existing antibiotics are gradually losing some of their power, while new innovations to replace them are struggling to be developed. This has allowed drug-resistant superbugs to emerge, making today’s crisis of antimicrobial resistance, or AMR, grow deadlier each year.
In a study published in January in the medical journal The Lancet, researchers linked drug-resistant superbugs to at least 4.95 million deaths across the planet in 2019. Direct deaths from AMR totaled 1.27 million. Consider that a 2014 analysis estimated the global death toll at just 700,000 per year.
To address this emergency, it’s important to recognize how, exactly, the AMR threat became so grave. That story stretches back to the beginning of the 20th century, with the creation of the world’s first antibiotics.

A Revolution in Modern Medicine

It’s hard to overstate the significance of the first antibiotics for the practice of medicine, and indeed for human life as we know it. Before these drugs became available, bacterial infections were a common cause of death. Superficial wounds could prove life-threatening, mothers and children died in childbirth at alarmingly high rates, and even minor surgeries came with an enormous risk of death from infection.
That all changed in the early 1910s, with the release of Salvasaran, the first antibacterial approved in the United States. The decades that followed saw an explosion of innovation in the development of new antibiotics.
To date, the Food and Drug Administration (FDA) has approved 164 antibacterial drugs, according to a report released in February by the Biotechnology Innovation Organization (BIO). But as that study notes, antibacterial development reached its apex between the 1940s and 1960s, when 15 drugs with novel targets earned approval. Since then, however, the pace of antibacterial innovation has slowed drastically. In the last 35 years, the FDA has approved only one antibacterial new chemical entity for a novel target.
The lack of new antibiotics is a key problem in today’s AMR crisis. An overreliance on the same antibiotics over the course of decades has given rise to bacteria, fungi, and other microorganisms that are resistant to these drugs.

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