World Bank Report: Health expenditure to increase by $1 trillion per year, here's why

Written By Pooja Makkar | Updated: Nov 24, 2023, 11:20 AM IST

The World Bank's report states the ineffectiveness of antibiotics. Know what is antimicrobial resistance and how can it be solved.

Antimicrobial resistance means the ineffectiveness of essential medicines that fight infection. It is among the ten biggest threats to human life. According to WHO estimates, more than 1 million people die every year in the world due to antimicrobial resistance i.e. ineffectiveness of medicines. In South Asian countries, 4 lakh people are dying due to such dangerous infections on which no medicine is effective. The World Health Organization has estimated that if the problem is not solved at the level it is today, then by 2050, 10 million people in the world will die because medicines will not be effective on them.

The World Bank's most recent report states that the ineffectiveness of antibiotics might cause a 3.8% decline in world exports over the next 25 years as well as a 7.5% annual decline in the production of livestock products like meat and dairy. Additionally, healthcare spending will rise by $1 trillion. 

Why medicines are becoming ineffective?
A fixed dose of antibiotics is given to prevent infections caused during surgery and chemotherapy during cancer treatment. But if these medicines are used repeatedly for a long time, their effect starts reducing.

Additionally, reserve antibiotics are losing their efficacy. Report from AIIMS: 70% of patients' lives are in jeopardy.

According to a new analysis by AIIMS, no antibiotic medicine is working on many patients suffering from serious infections admitted in ICUs across the country. There is a danger of such patients dying without any reason. The state of antibiotic resistance has gotten so bad that even the newest medication, which the World Health Organization has placed in the reserve category, is sometimes not effective. Reserve category medicine means that it should be used only on selected occasions.

However, it was observed that even the most effective antibiotics were found to be effective only in 20 percent of the cases. That means the remaining 60 to 80 percent of patients are in danger and may lose their lives. The reason for this is the indiscriminate use of antibiotics by patients and doctors as per their wishes.
 
The largest medical research institution in India, ICMR, gathered information from 21 hospitals nationwide between January and December of the previous year. One lakh samples from ICU patients were taken at these facilities. 1747 different kinds of infection-causing bacteria were discovered throughout this examination. Two of these bacteria—Klebsiella pneumonia and E. coli—have emerged as the most obstinate of the lot. The patients who were infected with these bacteria were not responding to any antibiotic medication.

In 2017, medicines worked on 8 out of 10 patients suffering from E. coli bacteria. But in 2022, the drugs worked for only 6 out of 10 patients.
6 out of 10 patients suffered from Klebsiella pneumonia infection in 2017 and the medicines worked. But in 2022, medicines were working on only 4 out of 10 patients. The infection is reaching the blood of the patients and making them sicker and sicker.

The problem of antibiotics not working is not limited to serious patients admitted to the hospital.

Common antibiotics taken in cases of stomach upset are also proving ineffective on the patients.

Why is the risk of fatal infection higher in hospitals?
Many bacteria and germs grow in the ICU in hospitals, on catheters, cannulas and other devices inserted into the patient. These infections make already sick and weak immune patients more sick. Patients admitted to ICU for a long time are at increased risk of such infections.

Now these infections are reaching the blood which means that there is a risk of sepsis in the entire body – when this condition becomes serious, the patient's organs gradually stop functioning which is called multi-organ failure.

How can the problem of antibiotic resistance be solved?
ICMR has guidelines for hospitals and doctors regarding each case where the antibiotic should be used or not but these are not followed. 

People unknowingly get antibiotics through meat, milk and eggs obtained from poultry i.e. chicken, goat and cow, buffalo.

The dissolution of antibiotics in groundwater through hospital and industry waste has also been confirmed in many researches. Infection control work is also being done to control infection-causing bacteria in hospitals, which have also been named superbugs. However, it may take several years for that network to be ready and fully functional in small and big hospitals across the country.

These medicines are also becoming ineffective due to the patients themselves taking antibiotics directly from the chemist and then abandoning them after completing half the course.