Superbugs on the Rise: The Deadly Cost of Antibiotics' Inaccessibility

A groundbreaking global study has revealed a stark disparity in access to antibiotics for drug-resistant infections in low- and middle-income countries (LMICs). Despite the rising threat of antimicrobial resistance (AMR), fewer than 7% of patients suffering from severe drug-resistant infections in these regions receive the appropriate medications, according to new findings published in The Lancet Infectious Diseases (1^✔ ✔Trusted Source
Estimated undertreatment of carbapenem-resistant Gram-negative bacterial infections in eight low-income and middle-income countries

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The Stark Reality of Carbapenem-Resistant Infections

Led by the Global Antibiotic Research and Development Partnership (GARDP), the study analyzed eight countries—Bangladesh, Brazil, Egypt, India, Kenya, Mexico, Pakistan, and South Africa. Researchers estimated that in 2019, 1.5 million cases of carbapenem-resistant Gram-negative (CRGN) infections occurred in these countries, resulting in nearly 480,000 deaths. Yet, only 104,000 courses of antibiotics capable of treating these infections were distributed—covering a mere 6.9% of the estimated need. Kenya had the lowest access rate at just 0.2%, while Egypt and Mexico reached 14.9%.

Dr. Jennifer Cohn, global access director at GARDP and a senior author of the study, emphasized the dangerous feedback loop this situation creates. "Lack of access not only leads to avoidable deaths but also accelerates antimicrobial resistance. Without the right drugs, patients may receive multiple ineffective antibiotics, extending treatment duration and giving bacteria more time to adapt."

While AMR has largely been framed as a consequence of antibiotic overuse, Cohn warned that the narrative has neglected the equally critical issue of access. "We’ve focused so much on limiting use to curb resistance that we’ve ignored that millions simply aren’t getting treated at all," she said.

The study’s authors are calling for a global push akin to early 2000s HIV treatment efforts, which expanded access to life-saving antiretrovirals in sub-Saharan Africa. They propose similar strategies for antibiotics—such as voluntary licensing agreements that would allow generic production and reduce prices. One such effort is already underway, with GARDP and pharmaceutical company Shionogi aiming to broaden access to cefiderocol, an antibiotic that targets CRGN infections.

Health equity advocates believe this moment demands a bold reset in how the world tackles AMR. Prof. Alison Holmes from the University of Liverpool, who leads the global Centres for Antimicrobial Optimisation Network, urged immediate global intervention. “Without urgent action to close treatment gaps, the already devastating toll of AMR will become even more inequitable,” she warned.

The researchers are now advocating for a global treatment access framework similar to the HIV ‘care cascade’, with measurable targets ensuring that patients are diagnosed, treated effectively, and monitored for outcomes.

Ensuring access to effective antibiotics is no longer just a matter of public health—it is a matter of global justice.

Reference:

1. Estimated undertreatment of carbapenem-resistant Gram-negative bacterial infections in eight low-income and middle-income countries - (https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(25)00108-2/fulltext)

Source-Medindia