The Lancet Series on Antimicrobial Resistance: The need for sustainable access to effective antibiotics

Antibiotics are a global public good that prolong lives, reduce disabilities, and enable other life-saving medical interventions such as surgery. Antimicrobial resistance threatens this backbone of modern medicine, and is estimated to have contributed to almost 5 million deaths in 2019 alone. As the world’s set of effective antibiotics narrow, the very young, very old and severely ill will be the ones to suffer the most, even in Singapore and other high-income countries.

In the Lancet Series on Antimicrobial Resistance: Sustainable Access to Effective Antibiotics, which was launched at a side event in Geneva during the World Health Assembly, new modelling analysis estimated that improving and expanding existing tools to prevent infections, such as hand hygiene, regular cleaning and sterilisation in healthcare facilities, availability of safe drinking water and effective sanitation in the community and use of paediatric vaccines, could prevent over 0.75 million deaths associated with AMR every year in low and middle-income countries. The authors also propose ambitious but achievable global targets for 2030: the “10-20-30 by 2030” goals.

These are:

  • A 10% reduction in deaths from antimicrobial resistance by scaling up interventions that prevent infections in the first place, reducing both antibiotic use and resistance
  • A 20% reduction in inappropriate human antibiotic use by reducing the use of antibiotics for mild respiratory infections that generally do not require antibiotics
  • A 30% reduction in inappropriate animal antibiotic use to be achieved by incremental actions in many sectors, including that all antibiotics should be given under the guidance of a veterinary professional.

Prof Hsu Li Yang, Vice Dean of Global Health, and also one of the Lancet series authors, said that several recommendations – such as improving vaccination rates as well as infection prevention and control in healthcare facilities – are relevant even to Singapore.

“We will need to better identify and record local deaths due to AMR. We should also do our part in leading in the investment, development and testing of affordable new therapeutics and diagnostics that can be used not just in Singapore, but also in LMICs”