Antimicrobial resistance (AMR) is a priority — yet an unresolved — global health problem.
Antimicrobials have helped reduce the individual and societal impact of many diseases. Therefore, the loss in the ability to effectively prevent and treat infections with antimicrobials that follows from a rise in AMR will significantly reduce the advantages achieved in modern medicine. AMR must not be seen just as a threat to the future. It is an active problem that — in Europe alone — over 125,000 deaths were estimated due to infections caused by AMR microorganisms in 2019.
Why is AMR a complex problem?
AMR is a societal problem resulting from the interaction of many contributing factors that impact antimicrobial use and/or infection control practices differently. Various sectors, including human and animal medicine, food and pharma industries, farming and environmental safety (among others) are involved.
The mixture of stakeholders, interests and priorities adds a considerable amount of unpredictability to the development and control of AMR. From a pragmatic standpoint, the complexity of AMR as a problem leads us to an unfortunate, but realistic conclusion: AMR cannot be solved. This reality must not lead us to inaction since AMR can be mitigated and controlled.
As a society, we must actively seek and apply multiple incremental improvements. The sooner broader society and the healthcare sector realise this, the sooner there will be an effective response towards combating AMR.
The current tragedy of AMR is a double failure of implementation due to insufficient resource allocation and ineffective or non-existent cooperation.
How should we approach AMR?
We advocate for a ‘trans-trans’ approach. If the response needs to be proportionate to the magnitude of the problem, society must have both a transnational and a trans-sectorial approach. Since AMR does not recognise countries, species or any other borders, our response should not be restrained by boundaries. Due to the intimate interrelation between humans, animals and the environment, our response must be from a One Health perspective.
If we acknowledge the relevance of AMR as a societal problem and we agree with the necessary approaches — where is the tragedy of AMR, then? The current tragedy of AMR is a double failure of implementation due to insufficient resource allocation and ineffective or non-existent cooperation.
Without sufficient resources, we will never start the transition from a world of ideas to a world of real solutions. Therefore, governmental decision-makers — informed by infection professionals and others — must have the vision and determination to adopt a temporal perspective beyond classical electoral cycles. Even with the necessary resources, the risk of failing to implement the necessary solutions will remain high without cooperation on a large scale.