The availability of vaccines, clean water and sanitation, and the development of methods to prevent infections could prevent 750,000 deaths linked to antimicrobial resistance (AMR) each year, according to a study by the Lancet magazine released this Thursday.

It is estimated that 7.7 million deaths worldwide each year are caused by bacterial infections, which represents one in eight of the total and makes these diseases "the second leading cause of death worldwide". Of that total, 4.95 million are associated with bacteria that have developed resistance to antibiotics, according to a Lancet statement on the study.

The conclusions are from scientists linked to a new Lancet Series, with scientific articles that include two or more reviews, analyzing a topic in depth. In this case, the subject is AMR and the analysis is part of a set of four articles published in the scientific journal.

Last week, the World Health Organization (WHO) published an updated list, including 15 bacteria that it considers a threat to human health due to their growing resistance to antibiotics. The United Nations health agency once again warned of the danger of the growing resistance of certain pathogens and called for the development of new treatments.

"Access to effective antibiotics is essential for patients worldwide. Failure to provide them puts us at risk of failing to meet the UN sustainable development goals for child survival and healthy aging," says Professor Iruka Okeke, from the University of Ibadan (Nigeria) and co-author of the series, quoted in the statement.

"Effective antibiotics prolong life, reduce disability, limit healthcare costs, and enable other life-saving medical interventions, such as surgery. However, antimicrobial resistance is rising—accelerated by inappropriate antibiotic use during the COVID-19 pandemic—threatening the backbone of modern medicine and leading to deaths and illnesses that would once have been preventable," she adds.

Babies and children, the elderly and those suffering from chronic diseases are the most vulnerable to AMR, due to their increased risk of contracting bacterial infections in general. It is estimated that one third of newborn deaths worldwide are caused by infections and half of them by sepsis (a potentially fatal response of the immune system to a serious infection).

In the case of the elderly and those with chronic diseases, hospitals represent a "significant risk", with antimicrobial resistance "compromising the safety of common medical procedures such as organ transplants, joint replacements, cancer chemotherapy, and treatment of non-communicable diseases such as diabetes, cardiovascular disease, and chronic lung disease".

In a commentary on the work, Nour Shamas, a clinical pharmacist and member of the WHO working group on AMR survivors, points out that antimicrobial resistance "can affect anyone", arguing that "policy makers, health professionals, patients, and the general public" should call for the reduction of "the spread of infectious diseases and the development of resistance" and ensuring "access to antimicrobials", as well as that they are used judiciously, "becomes an urgent global priority".

To fight against AMR, the most important thing should be the prevention of infections, argue co-authors Joseph Lewnard, Professor at the University of California, Berkeley, and Yewande Alimi, from the Centers for Disease Control and Prevention - Africa.

Of the 750,000 AMR-related deaths that could be prevented each year, the scientists estimate that improving infection prevention and control in health care settings could save up to 337,000 people, universal access to safe water and sanitation close to 247,800, and expanding childhood immunization and introducing new vaccines could save 181,500 lives.

Reducing the use of antibiotics when the benefit to patients is limited and investing in ensuring global access to new antibiotics, vaccines and diagnostic tests are other measures advocated in the study, which also calls for "increased funding for AMR prevention programs", considering that this "falls significantly short" of that allocated to "diseases with smaller burdens, such as HIV, malaria, and tuberculosis".

Co-author Ramanan Laxminarayan, from Princeton University (USA) and president of the public health research organization One Health Trust, believes that the development of new antibiotics will not reduce the impact of AMR unless they are guaranteed broad access.

"Reducing the cost of drug development would help keep antibiotics affordable, as demonstrated by public-private partnerships for medicines to treat malaria and neglected tropical diseases," he argues.

For 2030, the study proposes "ambitious but achievable global targets" such as "a 10% reduction in AMR mortality by scaling up public health interventions to prevent infections (...) 20% in inappropriate antibiotic use in humans (...) and 30% in inappropriate use" of these drugs in animals.

The Lancet statement is being released on the eve of the World Health Assembly (May 27 to June 1, in Geneva), during which the authors of this Lancet Series are expected to "call for urgent global action on antimicrobial resistance (AMR) and ensuring sustainable access to antibiotics", so that there is not "a steady increase in the number of deaths" due to associated infections.

Read Also: Covid-19. Excessive use of antibiotics may have aggravated resistance (Portuguese version)