Antimicrobial Resistance (AMR) occurs when bacteria, viruses, fungi and parasites no longer respond to medicines, making infections harder to treat and increasing the risk of disease spread, severe illness and death. Drug-resistant infections, in both humans and animals, are on the rise globally. The AMR pandemic can have significant consequences on global health and economy.
Antibiotics are used to treat or prevent bacterial infection: they kill bacteria and/or prevent them from reproducing and spreading. Modern medicine, including surgeries, chemotherapy, organ transplantations and many other procedures require effective antibiotics. AMR occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to medicines, making even relatively harmless infections harder or impossible to treat. Medical procedures – including caesarean sections, hip replacements or even wisdom tooth removals – become riskier.
The World Health Organisation (WHO) has declared AMR as one of the top 10 global public health threats facing humanity. The currently available antibiotics are becoming increasingly ineffective as drug-resistance spreads worldwide, leading to more-difficult-to-treat infections and death. This is already a major concern for healthcare systems in developed and developing countries alike. AMR was associated with almost 5 million deaths globally in 20191 alone and, left unaddressed, it is predicted to present a greater danger to humankind than cancer by 20502.
As evidenced by the COVID-19 pandemic, a global health crisis can have significant implications not only for the directly affected individuals and the healthcare systems, but for all areas of the societies and economies. Indeed, the World Bank estimates that drug-resistant infections could cause global economic damage similar to – or worse than – the 2008 financial crisis, including notable negative impacts on poverty, development, world trade and livestock output. In addition to death and disability, drug-resistant outbreaks and increased/prolonged illness can result in longer hospital stays, financial challenges for those impacted, as well as staffing, productivity and delivery problems for companies and public services.
The worrying trend could be reversed, or at least slowed down, by addressing the root causes – particularly the overuse and misuse of antibiotics in human and veterinarian health – and encouraging investment and innovation on the solutions side. AMR is a complex problem that requires a multisectoral approach and better governance globally. Companies and investors also have a role to play in bringing about a more positive trajectory.
How does the Council on Ethics work with AMR?
The Council on Ethics considers AMR a material, systemic risk to both societies and investments, and is committed to raising awareness of the topic through different channels as well as effecting change through engagement with relevant companies. Given the complexity of the problem, partnerships and sector-wide initiatives are likely to be our primary tool for tackling AMR. Since an estimated 70% of global antimicrobial use by volume occurs in animal agriculture, the Council joined FAIRR’s related collaborative engagements in July 2023. Together with a group of other investors, we seek to encourage responsible use of antibiotics in line with WHO guidelines across the animal protein value chain, with one of the projects addressing animal pharmaceutical companies and the other fast-food restaurant chains.
1The Lancet (2022) Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis, https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02724-0/fulltext
2Review on Antimicrobial Resistance (2016) Tackling drug-resistant infections globally: Final report and recommendations, https://amr-review.org/sites/default/files/160525_Final%20paper_with%20cover.pdf