Combatting Antimicrobial Resistance | Institute for Health Policy Leadership

Computer illustration of bacteria of different shapes, including cocci and rod-shaped bacteria.

By IHPL - January 1, 2025

Antimicrobial resistance (AMR) poses a serious challenge to the successful prevention and treatment of infections caused by bacteria, viruses, fungi, and parasites.¹ Antimicrobials, such as antibiotics, antifungals, antiparasitic, and antivirals, are drugs used to combat infections in humans, animals, and plants, and AMR occurs when the infection-causing microorganisms evolve and stop responding to treatments, making infections harder to manage and raising the risk of disease transmission, severe health complications, and death.^1,2

The World Health Organization estimates that bacterial AMR was responsible for 1.27 million deaths in 2019 globally.^3,4 Across the nation, the Centers for Disease Control and Prevention (CDC) estimates that over 2.8 million Americans experience AMR infections annually, with more than 35,000 deaths as a result.⁵ In a study published by The Lancet, it is estimated that over 39 million people may die from antimicrobial resistant infections in the next 25 years.⁶ Furthermore, the World Bank estimates that AMR could result in an additional $1 trillion in healthcare expenses by 2050, along with annual gross domestic product (GDP) losses of up to $3.4 trillion by 2030.^4,7

AMR is a global challenge that occurs naturally over time as pathogens undergo genetic changes. Microorganisms, such as bacteria, viruses, parasites, and fungi, can naturally develop resistance through genetic mutations or by acquiring resistance genes from other organisms as part of the normal evolutionary process. ⁸Human activities, particularly the misuse and overuse of antibiotics in humans, animals, and plants, accelerate the spread of antimicrobial-resistant germs, making infections harder to treat.^4,9

Research from the CDC reported spikes in antibiotic usage and resistant infections in U.S. hospitals during the first years of the COVID-19 pandemic, with a 15% rise in both hospital-onset infections and related deaths. ⁵Therefore, in October 2020, the U.S. Department of Health and Human Services (HHS) issued the National Action Plan for Combating Antibiotic-Resistant Bacteria (CARB), 2020-2025 (2020 Plan). The 2020 Plan maintains the five original goals of the National Strategy for CARB that was released in September 2014 and includes new objectives and targets aimed at achieving the goals. These five goals include: (1) slow the development and spread of resistant bacteria and infections; (2) enhance national One-Health surveillance to address resistance; (3) promote rapid and innovative diagnostic tests for resistant bacteria; (4) accelerate research and development of new antibiotics, therapeutics, and vaccines; and (5) strengthen international collaboration for antibiotic resistance prevention, surveillance, control, and research. ¹⁰

Beginning in 2025, the CDC will release new estimates for at least 19 AMR threats and update the U.S. burden of AMR by pathogen in a digital format. Going forward, the CDC plans to release updates every two years in an effort to provide high-quality data to guide the efforts against AMR.¹¹

Of note, some of the most dangerous antibiotic-resistant bacteria can spread within and between healthcare facilities, increasing the threat of AMR. According to the CDC’s 2019 AR Threats Report, seven of the identified urgent or serious bacterial threat can lead to healthcare-associated infections (HAIs). The report also estimated that treating infections caused by these germs could cost nearly $5.6 billion annually.¹² As part of the American Rescue Plan Act of 2021, the CDC funds many efforts to prevent AMR and HAIs through Healthcare-Associated Infections and Antimicrobial Resistance (HAI/AR) Programs within health departments.¹¹ Currently, the CDC funds a network of 64 health department HAI/R Programs with the goal of preventing the occurrence and controlling the spread of HAIs and AMR threats; enhancing the ability to detect, respond to, and contain AMR within healthcare environments; encouraging antibiotic stewardship, which involves assessing and optimizing how providers prescribe antibiotics and how patients use them; and strengthening healthcare safety and quality standards.¹³

AMR is an escalating global health crisis that can jeopardize the effectiveness of treatment for a. a range of infections, resulting in significant morbidity and mortality. The ongoing efforts by the CDC and health departments to monitor AMR and HAIs will be crucial in ensuring a healthier future. Each person has a part to play in engaging in safe, appropriate antibiotic usage. Using antibiotics only when necessary and as prescribed is a crucial way to protect oneself and one’s family while also fighting against AMR.

Author Bio:

Renée Chuang, M.S.

Renée completed her undergraduate education in Biochemistry and Sociology at the University of Oregon. She then received her Master of Science in Global Health at National Taiwan University. Currently, she is pursuing her DrPH in Health Policy and Leadership at Loma Linda University School of Public Health. Her research interests include patient-provider relationships and quality of care. When she is not working on her dissertation, she can be found exploring local coffee shops or training for a marathon.

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