Governments are not doing enough to minimize the spread of resistant bacteria

The threat posed by antimicrobial resistance is urgent and spares no country – including Brazil.

According to The Lancet, 63 deaths per 100,000 are associated with AMR in Brazil and Paraguay, a rate that exceeds the average for Latin America and the Caribbean. AMR-associated deaths in Brazil are second only to cardiovascular diseases and cancers. This growing crisis has profound implications for healthcare, but also for the very premise of human longevity. AMR infections will increasingly become a concern for Brazil as the proportion of the population aged 65 and older is expected to increase threefold by 2050 – and older adults disproportionately suffer from diseases where drug resistance poses a real challenge.

Germs, of course, naturally build up resistance to treatments over time; that’s basic biology. But, historically, antibiotic innovation kept pace with evolving threats through the development of new medications.

Today, the pipeline for antibiotics is nearly dried up. And governments are not doing nearly enough to implement programs that could help reduce the need for antibiotics and minimize the spread of resistant bacteria. Brazil can – and should – aim to change that.

A 2021 report by the Global Coalition on Aging – measuring AMR preparedness among developed nations – found Brazil to be lagging behind in several areas.

Brazil has work to do in the areas of prevention and stewardship. The country still has high levels of hospital acquired infections and sanitation-related deaths, driven largely by weak underlying healthcare infrastructure. Furthermore, data suggests that the prescriptions common antibiotics is increasing.

Another key challenge Brazil faces is lagging regulatory approval. Outside of Brazil, many countries have used expedited regulatory pathways designed to spur innovation to gain access to new antibiotics sooner. One example is Ceftazadine + Avibactum, which was approved by the United States’ regulatory body in February 2015 as AVYCAZ®. This same antimicrobial, critical for treating many resistant gram-negative pathogens, was only approved by Brazil’s ANVISA in April 2022, a seven-year lag.

There are steps that can be taken to fix this problem.

Brazil needs to raise awareness of the dangers of AMR and promote the proper prescription of antibiotics. Campaigns to educate community health agents on AMR are a step in the right direction, and should be expanded.

Secondly, Brazil needs to reform its regulatory processes. The government needs to ensure more swift approval of existing and novel antibiotics. In a recent report examining Brazil’s regulatory processes, One Health Trust recommended that the Brazilian government create dedicated approval pathways for antimicrobials that target more serious infections to help vital new drugs reach patients sooner. Likewise, the government should take actions to ensure needed antibiotics, both new and existing, are accessible to the patients who need them, no matter where they live.

Last, as Brazil prepares to lead the G20 next year, the country has an opportunity not only to take greater ownership of efforts to combat AMR at home, but also to step into a leadership role on AMR on the global stage. Without a change in course, Brazilians, and indeed all of us, may find ourselves living in a world without effective antibiotics. With dedicated funding, new and approved antibiotic developments, and greater awareness among the public and the medical community, Brazil can step up to help defeat AMR and protect the future of its health system.

(Translated from the original Portuguese)