General News
15 November, 2025
Call the Doctor with Dr Felix Ritson: Threats to Global Health
The World Health Organisation has published a list of the top 10 threats to global health, one of which is Antimicrobial Resistance (AMR).
The World Health Organisation has published a list of the top 10 threats to global health, one of which is Antimicrobial Resistance (AMR).
The term AMR, otherwise commonly referred to as antibiotic resistance, is the development of bacteria and fungus (microbiota) that are immune to antibiotics and antifungal medication.
Each time a medication is used to kill a bacteria or fungus, there is a chance the bacteria or fungus will adapt and become resistant to the effects of the medication.
Many people have heard of AMR, but few appreciate the seriousness of the matter.
Before antibiotics were invented, it was common for people to die from infection.
Young and healthy people would die helplessly from conditions that today seem relatively minor such as a simple skin infection or pneumonia.
This is a reality not known to modern society, but a reality that could very likely return, and come back even worse than before.
The problem with antibiotic resistance is not just that there is no treatment, but also that when a bug adapts to overcome the effects of a medicine, it also usually adapts to become more aggressive and harmful.
For example, whilst results differ between studies, it is commonly considered that Vancomycin-resistant enterococcus faecalis bacteria (VRE) kills 50% of people infected.
This is not a problem for future generations, it is a problem now.
AMR caused 4.3% of all deaths globally in 2022.
Already just under 50% of enterococcus faecalis infections in Australia are resistant to Vancomycin (VRE).
Data suggests 2% of the global population have VRE living on them at any given time, up to 11% for people who work with livestock.
By 2030 it is predicted that AMR will reduce global GDP by between 1 to 3.4 trillion dollars per year.
Without effective antibiotics, and with very dangerous bacteria living amongst us; our ability to provide healthcare will change dramatically.
Surgeries like joint replacements or organ transplants may become simply too risky.
Childbirth, especially via caesarian section, may again become a seriously life threatening undertaking.
Chemotherapy may become in essence unavailable. Whilst one of the greatest dangers of being admitted to hospital is already obtaining a “hospital acquired infection”, the situation in the future could be much worse.
Our way of life could change in regards to how we take risks.
When a cut to the skin could risk your life, the prospect of going hiking, riding a bicycle or even playing sport looks very different.
Sadly there is no real hope for the creation of stronger antibiotics.
There are very few prospects for the development of new medications, and bacteria and fungus will simply adapt to these anyway.
What we as a society need to do is use less antibiotics.
Thankfully many infections do not require, or even benefit from antibiotics.
Most infections of the airways (bronchitis), throat (tonsillitis), sinuses (sinusitis) and ears (otitis media) should not be treated with antibiotics.
Even 80% of bladder infections (UTIs) will resolve without antibiotics.
In upcoming columns I'll outline the management of these infections and when antibiotics should, or should not, be used according to up-to-date gold-standard guidelines.
I encourage the reader to seek independent medical advice when unwell, and also to become active participants in their healthcare by asking about their treatment options, including whether antibiotics are required.
Another driver of AMR is the use of antibiotics on animals, primarily livestock.
I do not however have the expertise to write about how necessary this is, and to what extent antibiotics are overused in the farming industry.