Antibiotic resistance is the plague of the 21st century

Every year, drug-resistant bacteria kill as many people as traffic road accidents worldwide. Superbugs may cause premature deaths of 39 million people and animal production losses equivalent to 953 billion dollars by 2050. People over 70 years old and those living in low and middle-income countries in Sub-Saharan Africa and Asia will be hit the hardest.

Deaths due to drug-resistant bacteria will increase by 60% in the next 25 years unless appropriate action is taken.

According to the World Health Organization, antimicrobial resistance is one of the top ten global threats to human health.

On 18 November, Russian and international medical experts, veterinarians and environmentalists held a Round Table on the occasion of the World Antimicrobial Resistance (AMR) Awareness Week. The event took place at the platform of Rossiya Segodnya International Multimedia Press Center in Moscow.

It was organized by the offices of the Food and Agriculture Organization of the United Nations (FAO), the World Organisation for Animal Health (WOAH), the World Health Organization (WHO), and the UN Environment Programme (UNEP) in the Russian Federation.

“All the environments, soil, air, and waterbodies make up a single macrobiome featuring microorganisms that we generously share with each other and with other living organisms on the planet. However, it is in the agricultural sector where the risks to human, animal, and environmental health are the most clearly interconnected,” Oleg Kobiakov, Director of the FAO Liaison Office with the Russian Federation in Moscow, emphasized in his opening remarks.

“About 80% of all diseases that have made a spillover to humans over the past 50 years originated in nature: just think of AIDS, avian influenza, Marburg and Ebola fever, and, lastly, COVID-19. Therefore, our work on surveillance of transboundary animal diseases is the practical implementation of the One Health approach,” Oleg Kobiakov noted.

“In animal production, antibiotics are still used as growth promoters, for preventative rather than therapeutic purposes, which is completely unacceptable. While antimicrobial drugs are administered orally or by injection in medicine and animal production, they are simply released into the environment in crop production and aquaculture.

Thus, trying to, for example, treat our aquarium fish or rid our crops of rot, we generously “fertilize” the entire environment with antibiotic resistance genes.

Developed countries, including Russia, sometimes lack the general understanding of this matter, thinking that all these problems only concern developing countries of the world. However, as the recent pandemic has shown, infections know no borders. Therefore, only a unified coordinated approach can address, or at least limit, the spread of this threat, which is one of the ten most serious public health threats, according to WHO,” the head of the FAO Moscow Office highlighted in conclusion.

The UN Environment Programme (UNEP) runs its own global campaigns, for example, #BeatPollution: towards a pollution-free planet. This campaign is “aimed at combatting air, land and water pollution, which indirectly contributes to solving the problem of AMR, since pollution can increase microbial resistance. The campaign emphasizes the link between pollution, climate, and human health,” Vladimir Moshkalo, UNEP Representative in the Russian Federation, said.

UNEP is a key partner in the implementation of the global One Health initiative. This concept “highlights the inextricable link between the health of people, animals and the state of the environment (ecosystems)”, Vladimir Moshkalo noted.

The impact of bacterial AMR on human health (data for 2019) is not limited to the spread of such diseases as tuberculosis, influenza, and HIV/AIDS, Danilo LO-FO-WONG, Regional Adviser on Control of Antimicrobial Resistance at the WHO Regional Office for Europe, stressed for the audience during his presentation. Globally, AMR is directly related to 1.3 million deaths and indirectly associated with almost 5 million deaths.

The expert noted that this phenomenon “claims lives, requires financial costs, undermines well-being, and reverses the progress of public health programmes”.

The new guidance materials from the WHO Office for Europe presented by Danilo LO-FO-WONG included the “Resource guide for the implementation of the Roadmap on AMR”, “Reports on AMR/AMU surveillance”, and the “Building the evidence for the use of bacteriophage therapy”, “Food safety surveillance”, and “Doctor/patient dialogue” brochures.

Annual losses due to the resistance include workforce and productivity losses (minus USD 443 billion), and costs of treating resistant bacterial infections (minus USD 412 billion). According to forecasts, due to the increasing antibiotic resistance, the average life expectancy can be expected to reduce by approximately 1.8 years by 2035, the WHO expert warned.

“Russia has been consistently implementing the Strategy to prevent the spread of antimicrobial resistance in the healthcare sector for the period up to 2030,” Professor Roman Kozlov, Rector of Smolensk State Medical University, chief freelance specialist in clinical microbiology and antimicrobial resistance at the Ministry of Health of Russia informed the Round Table participants and the online audience.

“Russia has a methodological verification centre for antimicrobial resistance: the Reference Centre for Clinical Pharmacology. Methods for antimicrobial susceptibility testing have been developed. The antibiotic resistance of bacterial pathogens is being monitored.

Taking into account the impact of AMR on the agricultural sector, the “Veterinary monitoring and risk analysis of antibiotic resistance in zoonotic bacteria” resistance map has been created. There is a guideline on ‘Antibiotic resistance of zoonotic and indicator bacteria isolated from food-producing animals’.”

“In the period from 2025 to 2050, a cumulative 92 million deaths could be prevented through improved treatment of severe infections and access to antibiotics and 11.1 million deaths could be averted through the development of drugs to treat problematic, highly resistant Gram-negative pathogens,” Elena Boyko, Deputy Director of the Department of Emergency Medical Care Organization and Health Risk Management at the Ministry of Health of Russia, shared the forecast.

The expert said that in 2021, “the order of the Ministry of Agriculture of Russia prohibited the use of drugs intended for the treatment of infectious and parasitic diseases of animals caused by pathogens and opportunistic pathogens without clinical confirmation of the diagnosis, as well as the continued use of such drugs if the treatment is ineffective. In 2023, a Federal Law introduced administrative liability in the form of a fine for over-the-counter drug sales.

In addition, in September 2025, the Ministry of Health of Russia together with Internet Development Institute ANO conducted a banner campaign about the spread of bacterial resistance to antibiotics. As a result, the total number of impressions exceeded 73 million.”

As part of improving the measures to prevent and limit the spread and circulation of pathogens with antimicrobial resistance, said Elena Boyko, the professional medical community developed modern, regularly updated recommendations on antimicrobial susceptibility testing.

Olga Ivanova, Leading Researcher at the Scientific Planning and R&D Department, Russian State Center for Animal Feed and Drug Standardization and Quality (VGNKI), spoke about the experience of developing plates to determine the minimum inhibitory concentration of antibacterial drugs for veterinary use.

As part of implementing the Strategy to prevent the spread of antimicrobial resistance, VGNKI takes part in the creation of a national collection of antibiotic-resistant strains of microorganisms and conducts a “Veterinary monitoring of bacterial resistance to antimicrobials and identification of genetic determinants of resistance from the environment”.

The specialists of the Center have developed a set of methods for confirmatory (based on mass spectrometry) and screening (immunochemical) determination of virtually all main groups of antimicrobials used in veterinary, including those critically important for medicine: colistin, fluoroquinolones and cephalosporins.

“The creation of the FAO Reference Centre in Russia and the Regional Laboratory Network on AMR in food and agriculture in Eastern Europe, Transcaucasia and Central Asia countries at the Central Research Institute of Epidemiology (CRIE) of Rospotrebnadzor in 2022 was a tangible result,” Igor Manzenyuk, Advisor to the Director of CRIE and Head of the FAO Reference Centre in Russia, said.

“The Network is one of the few platforms bridging the interests of representatives of various agencies,” the expert highlighted. “These are healthcare professionals, sanitary and epidemiological services, representatives of food safety agencies, veterinarians and other relevant specialists.

19 specialized laboratories from Armenia, Belarus, Kazakhstan, Kyrgyzstan, Russia and Tajikistan participate in the work of this information and analytical mechanism. Last year, they were joined by colleagues from Mongolia and Uzbekistan. Our Network’s website is regularly visited by experts from 30 countries, representing essentially all regions of the world.”

“The goal of our reference centre is to ensure food security for people in our country.  We conduct monitoring studies not only of antibiotic residues, but also of antibiotic-resistant bacteria,” Nina Kulikova, Head of the Reference Centre for Antibiotic Residues in Food Commodities and Food Products and Antibiotic Resistance of Bacteria of Rospotrebnadzor, said.

“Many people do not fully understand that antibiotic residues, first, can affect the human body by entering it with food and causing a toxicological effect, and also affect the body’s microflora, which can lead to imbalance and dysbiosis, thus increasing the risk of disease spread.

In order to develop a system and regulatory documents for identifying at least one antibiotic, there is a need for hundreds of studies, the selection of methods for preparing the samples of various food products and studies with the selection of reagents necessary for conducting them. Since 2018, not only the range of antibiotics has been expanded, but also the number of groups of antimicrobials has increased from 12 to 14.

The reference centre does molecular and genetic research of bacteria aimed at studying resistance markers that show which resistance genes circulate in the infectious agent in a specific territory or on a specific farm. This research establishes the potential of a particular microorganism to cause disease in humans or outbreaks in a given region or territory.”

BACKGROUND INFORMATION

The theme for the World Antimicrobial Resistance (AMR) Awareness Week 2025 was “Act Now: Protect Our Present, Secure Our Future”. The selected theme underscores the need to take urgent, decisive, united intersectoral action to address AMR, the growing global threat that is already harming our health, food systems, the environment and the economy.

Building on the momentum of the 2024 UN General Assembly High-Level Meeting on AMR, the current call is addressed to all stakeholders: governments, civil society, medical and veterinary professionals, farmers, environmentalists and the general public. The goal is to translate political commitments into tangible life-saving interventions.