The Global Crisis of Antimicrobial Resistance: Perspectives from Medicine, Geography, Food Science, and Chemistry

Antimicrobials are perhaps the greatest public health gain ever of humankind. As 2000 approached, many claimed penicillin to be the greatest discovery of the millennium; commercially available only from the early 1940s, the drug had already saved an estimated 200 million lives. Currently, however, the emergence and spread of multidrug-resistant pathogens threatens to reverse these benefits, and experts believe we are in the dawn of a post-antibiotic era. The global projections are alarming: AR infections may cause ten million deaths/year and lead all causes of mortality by 2050. Similar to other pressing global issues, the burden of AR is inequitably distributed, with 90% of AR infections occurring in Asia and Africa. This chapter discusses various forces, natural and anthropogenic, that contribute to AR, and how successful containment demands coordinated efforts from environmental, behavioral, and medical scientists, to public health educators and leaders in agricultural and international policy.