Bacterial superbugs are set to kill a disturbing number of people over the next few decades. In a new report published this week, scientists estimate that drug-resistant bacterial infections will kill more than 39 million people directly over the next 25 years. They also calculated that superbugs will contribute to nearly nine million deaths a year by 2050, barring significant action taken against antimicrobial resistance (AMR).
Scientists at the Global Research on Antimicrobial Resistance (GRAM) Project conducted the study, which was published Monday in The Lancet. The GRAM project is a collaboration between the University of Oxford in the UK and the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, and has received funding from other organizations such as the Wellcome Trust and the Bill and Melinda Gates Foundation.
It’s the second major report from GRAM scientists, following a 2022 study that estimated the recent death toll directly caused by drug-resistant infections (1.2 million deaths in 2019). This time, the researchers used relevant data collected across the world to look at both the past and future impact of antibiotic resistance on our mortality. All told, they analyzed 520 million individual records from various sources, such as hospital records or antibiotic use data, to estimate the toll of 11 broad types of infections (such as meningitis), 22 specific germs, and 84 different germ-drug interactions on people of all ages in 204 countries.
From 1990 to 2021, the researchers estimated that drug-resistant infections had directly killed over a million people annually, with 1.06 million deaths in 1990 and 1.14 million deaths in 2021. These infections also contributed to nearly five million deaths annually during that period, though the number had actually slightly lowered in 2021 relative to 2019. Total deaths in 2019 were higher, however, suggesting that this decline was likely caused by the covid-19 pandemic, which led to temporary decreases in many other infectious diseases as a result of increased social distancing. On the positive side, superbug-related deaths in children under five greatly decreased by 50% between 1990 to 2021, and the researchers predict that this trend will continue over the next 25 years. But deaths in general will likely increase in our near future, especially among older and more vulnerable people.
From 2025 to 2050, the researchers estimate that over 39 million people will be directly killed by drug-resistant infections, with 1.91 million deaths estimated in 2050 alone. Superbugs will further contribute to almost 170 million deaths during that time, they found, with 8.22 million deaths in 2050. But this toll won’t be equally distributed everywhere. A quarter of all estimated direct deaths (11.8 million) will occur in South Asia alone, for instance, and other parts of Asia as well as sub-Saharan Africa will see higher death totals, too.
The team’s findings are roughly in line with other estimates of antibiotic resistance’s deadly potential. A 2014 report commissioned by the UK government estimated that drug-resistant infection could kill up to 10 million people by 2050, for instance. If either estimate is correct, it’s possible that superbugs will eventually kill more people than cancer does annually.
There are some new antibiotics poised to reach the public in the near future, including antibiotics that can hopefully tackle drug-resistant strains of gonorrhea and other common superbugs. And there have been some success in incentivizing drug companies to once again pour their resources into antibiotic research and development. But much more action is needed to forestall the worst-case public health scenarios posed by these infections, the researchers warn. Otherwise, plenty of death and misery is sure to come.
“While there has been some progress tackling AMR in recent years, it isn’t enough and more needs to be done,” said Timothy Jinks, Head of Interventions in Wellcome Trust’s Infectious Disease team, in a statement from GRAM. “The GRAM estimates are an important tool in the fight against AMR, and we hope that global policymakers utilize the paper’s findings to make evidence-based decisions… Implementation of bold action on AMR can strengthen health systems and protect the world’s most vulnerable from infectious disease.”
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