Action Needed to Curb Antimicrobial Resistance, Reinsurance CEO Says

The COVID-19 pandemic demonstrated that medical providers continue to misuse antibiotics, exacerbating the long-recognized health threat posed by antimicrobial resistance, according to the head of Swiss Re’s Life & Health Reinsurance division.

As a viral disease, COVID-19 does not respond to antibiotics. The World Health Organization (WHO) found that just 8% of patients hospitalized with the coronavirus had bacterial co-infections, but that 75% received antibiotic treatment. Life & Health Reinsurance CEO Paul Murray said: “That means most patients received no benefit, while the risk of promoting antibiotic-resistant bacteria increased.”

Murray issued a public statement on the danger ahead of the U.N. General Assembly’s Sept. 26 high-level meeting on antimicrobial resistance. The General Assembly on Oct. 7 adopted a political declaration from the event that emphasizes the global health threat posed by antimicrobial resistance and calls for increased planning, funding, and multilateral coordination to bring it under control.

Bacteria, viruses, and other microbes naturally develop resistance to antimicrobials, but human intervention can also spur the process. Incorrect or excessive use of antimicrobials in humans, animals, and plants is the primary cause of creation of drug-resistant pathogens, the WHO says. The outcomes are terrible at the global level, the U.N. political declaration says: drug resistant bacterial infections were linked to 4.95 million deaths in 2019; of those, 1.27 million deaths were connected directly to bacterial antimicrobial resistance, one-fifth of those children less than 5 years old. Antimicrobial resistance could drive international healthcare costs up by $1 trillion annually as of 2050 and cut into gross domestic product by $1 trillion to $3.4 trillion each year by 2030.

The risk extends to insurance companies in varied sectors, industry representatives have told Leader’s Edge. That could encompass livestock that become resistant to the antibiotics used to keep them healthy or hospital patients with antimicrobial resistance whose medical costs (and thus insurance reimbursements) increase.

Climate change will increase the health threat, Murray said, “as geographies where drug-resistant microbes are likely to thrive are expanding. A warming planet is intensifying hazards that accompany extreme weather, as well, producing floods that can disrupt sanitation systems and potentially introduce resistant pathogens into the environment.”

He added: “Additionally, as some regions grow less hospitable, climate driven migration could become a larger source of international AMR spread like we have seen with the rise of drug resistant tuberculosis. People in informal settlements or refugee camps with inadequate health infrastructure may be particularly exposed.”

Murray cited the high-level U.N. meeting as a step in the right direction. The international body’s political declaration places a number of commitments on member states, including:

• By 2030, all states should be implementing national action plans against antimicrobial resistance that provide “appropriate and sustainable human and financial resources”
• Increase efforts to cut the deaths connected to bacterial antimicrobial resistance by 10% as of 2030 from the 2019 baseline of 4.95 million
• Ensure that financing is sustained and budget operations carried out within the national action plans
• Use national, bilateral, and multilateral means to spread financial resources and investments, with a focus on developing nations, to assist with conducting national action plans
• Increase the pace of work to provide universal health coverage and provide fair and timely availability of antimicrobials, vaccines, and diagnostics in developing nations.

“More such efforts are needed,” Murray said. “Ultimately, stewardship programs that promote the appropriate use of antimicrobials will be critical to preserving the effectiveness of existing medications. In addition, renewed drug development efforts to invent novel antibiotics are necessary, with resistant species emerging more quickly after a new drug’s introduction.”