Health and Healthcare Systems

Cutting pollution could slow the spread of superbugs

Climate change, biodiversity and antimicrobial resistance are also closely linked, with drugs further damaging ecosystems.

Climate change, biodiversity and antimicrobial resistance are also closely linked, with drugs further damaging ecosystems. Image: Unsplash/Roberto Sorin

Vanessa Racloz
Lead, Climate and Health, World Economic Forum Geneva
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This article is part of: Centre for Health and Healthcare

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  • By 2050 up to 10 million people a year could be killed by antimicrobial-resistant bugs.
  • Pollution from sectors such as pharmaceuticals, healthcare and agriculture are releasing antimicrobials and resistant microbes into the wider environment.
  • This increases the transmission, spread and development of antimicrobial resistance.
  • Climate change, biodiversity and AMR are also closely linked, with drugs further damaging ecosystems.

They might be tiny, but superbugs pose a big problem.

The growing swathe of microbes – bacteria, parasites, viruses and fungi – able to resist our current drugs are already causing millions of deaths a year. By 2050 that death toll could reach 10 million annually.

The environment has an important role to play in stopping the emergence, transmission and spread of antimicrobial resistance (AMR), according to a new UN report. Pollution, climate change and loss of biodiversity all contribute towards AMR, threatening human, animal and plant health.

Figure showing the predicted mortality from antimicrobial resistance compared with common causes of current deaths.
By 2050, deaths due to antimicrobial resistance could be comparable to current deaths from cancer. Image: UNEP

Problematic pollution

Microbes may either naturally develop resistance or acquire it from other microbes. So pollution from sites that contain antimicrobial drugs, or may host these resistant superbugs, creates a greater number of opportunities for this to occur.

Of particular concern is pollution from sectors including pharmaceuticals and other chemicals, agriculture and food, and healthcare. This could include hospital wastewater, effluent from pharmaceutical production and agricultural runoff, for example, which may contain both antimicrobials and resistant organisms.

The problem is exacerbated by poor sanitation, sewage and waste water in municipal systems.

The extent of the AMR problem was laid bare in a report the World Economic Forum produced in conjunction with BCG, the Wellcome Trust and the Novo Nordisk Foundation. It highlights the need for global coordination and leadership to develop new solutions to the problem. The AMR pandemic is in plain sight, it says, and we need to take steps now to avoid it becoming more deadly than the coronavirus pandemic.

‘’Global coordination and leadership along with robust national governance, planning, regulatory and legal frameworks are required to address the alarming increase in AMR associated to climate change,” say Dr. Shyam Bishen, head of Health & Healthcare at the World Economic Forum. “The AMR threat is real and grave. The World Economic Forum is working with its multisectoral partners to help generate research based evidence of the climate change impact on human disease areas including AMR. We must prepare global health system to respond to such crisis.”

Figure illustrating the environmental complexities in transmission and spread of antimicrobial resistance.
The environment has an important role in the development, transmission and spread of antimicrobial resistance. Image: UNEP

The connected web between climate change, biodiversity loss and antimicrobial resistance

Climate change is also driving greater risk of AMR, the UNEP report says. For example, higher temperatures can be associated with increased gene transfer – and therefore potentially resistance transfer – between microbes, as well as an increase in antimicrobial-resistant infections. Temperature, oxygen and carbon dioxide concentrations in the environment can also affect the survival and proliferation of bacteria.

Climate crisis, AMR and biodiversity are also closely interrelated. Biodiversity and healthy ecosystems are vital to supporting planetary health. But circulating antimicrobials and resistant microbes are joining climate change in damaging nature’s delicate balance, the UNEP warns.

For example, treating cattle with certain antibiotics changes dung beetle microflora, which in turn has an effect on the ecosystem service dung beetles provide. And circulating antimicrobials have an impact on natural microbial diversity, which provides an important reservoir for potential new treatments.


What is the World Economic Forum doing to improve healthcare systems?

Cutting problematic pollutants

The report recommends several steps to prevent and reduce these problematic pollutants. These include:

  • Robust national governance, planning, regulatory and legal frameworks, including better coordination and cooperation.
  • Increased global efforts to improve water management, sanitation and hygiene to reduce infections and the need for antimicrobials.
  • The inclusion of environmental considerations into national AMR action plans.
  • Establishment of international standards for microbiological indications of AMR from environmental samples.
  • The creation of financial incentives and schemes to tackle AMR.
A timeline showing the commercial deployment of antibiotics and emergence of antibiotic resistance.
It is only a matter of years before antimicrobial resistance develops. Image: UNEP
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