Beware of the emergence of superbugs

Scientists and medical practitioners have been warning us about the emergence of superbugs for quite some time now. However, this problem is not being taken seriously enough even though it has the potential of becoming a global public health threat.

So-called superbugs refer to strains of bacteria, viruses, parasites and fungi which have become resistant to most known forms of antibiotics. The growth and spread of antimicrobial resistance mean that common antibiotics used to treat common skin, respiratory, or urinary tract infections, for example, will no longer work.

World Health Organization now includes antimicrobial resistance amongst the 10 biggest threats to global health. A new report by the UN’s Environment Program has also cautioned against the dangers of pollution created by pharmaceuticals, agricultural and healthcare sectors. In addition to the devastating impacts of such pollution on the natural environment, these pollutants are providing the perfect opportunity for the emergence, transmission and spread of superbugs.

UN agencies warn that antimicrobial resistance could cause around 10 million deaths per annum by 2050, which is around the same number of deaths currently caused by different forms of cancer around the world. Besides the human suffering which would ensue due to the spread of superbugs, a rise in antimicrobial resistance would also impact economic productivity, and push millions of people into extreme poverty.

An antimicrobial crisis is already evident in poorer countries of the global south. A recent article in the reputable medical journal, Lancet, attributed over a million deaths to antimicrobial resistance.

Comprehensive data on the prevalence of antimicrobial resistance in Pakistan is not available. Yet, both multi-drug resistant and extensively drug resistant bacteria have been identified in the country over these past few years. Anti-drug resistant typhoid was first discovered in Hyderabad and has now spread significantly, especially across Sindh.

Pakistan unfortunately provides a fecund environment for antimicrobial resistance. The Ravi river was deemed to have the highest amount of pharmaceutical pollution in the world this past year, according to a study led by the University of York. Antibiotic use in Pakistan remains rampant. According to one study, Pakistan is the third highest antibiotic-consuming country among low- and middle-income countries. While antibiotics are technically not over-the-counter drugs, a wide range of them are easily available without any prescriptions.

There is a growing body of research which demonstrates how the health of humans, animals, plants and the natural environment are intertwined. The global community is still struggling to come out of the shadow of the Covid-19 pandemic, which was most probably a zoonotic disease linked to biodiversity loss and the growing stress on ecosystems. Similarly, higher temperatures and other extreme weather events, and rapid changes to land-use patterns, have been altering microbial diversity, especially in many poorer countries.

UNEP identifies several sensible measures to halt the growth of superbugs. Besides more judicious use of antibiotics, it stresses the need for more effective management of major pollution sources, including sanitation and other forms of municipal wastes.

Pharmaceutical companies are in the pursuit to develop drugs which can help fight against superbugs, but these drugs will be expensive, and one wonders if they will be able to keep up with the increasing microbial mutations. It would thus be wise if countries with limited resources begin paying attention to curbing pollution, reducing the use of antibiotics and providing basic services like clean drinking water and adequate sanitation to their populace. Such preventative measures will not only help prevent antimicrobial resistance but also lead to improved quality of life for many people who are currently denied such basic needs.

Published in The Express Tribune, April 21^st, 2023.

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