Global News Podcast Summary
Episode: The Global Story: Antibiotics - A casualty of war?
Release Date: February 16, 2025
Host/Author: BBC World Service
Duration: Approximately 28 minutes

Introduction

In this episode of the Global News Podcast by the BBC World Service, host Oliver Conway introduces a deep dive into the precarious state of antimicrobial resistance (AMR) and how contemporary conflicts are exacerbating this global health crisis. The episode, titled "Antibiotics - A casualty of war?", explores the historical significance of antibiotics, the rise of drug-resistant bacteria, and the profound impact of war on these developments.

The Evolution and Importance of Antimicrobials

Dominic Hughes, the program's global health correspondent, sets the stage by highlighting the transformative role of antimicrobial drugs in modern medicine. He emphasizes their critical importance both in civilian healthcare and on the battlefield.

Dominic Hughes:
"Antimicrobial drugs have transformed the health of humanity. Some of the greatest advances in those drugs' development have been forged in wartime."
(01:04)

Jonny Diamond, a contributor, elaborates on the history of antimicrobials, tracing their origins back to ancient civilizations and detailing key milestones in their development.

Jonny Diamond:
"Before antimicrobials were really discovered, life was essentially precarious. Even a relatively minor infection could prove fatal."
(02:24)

He further explains the discovery of penicillin by Alexander Fleming in 1928, noting its revolutionary impact during the Second World War and the subsequent “golden age” of antibiotic discovery up until the 1970s.

The Rise of Antimicrobial Resistance (AMR)

The conversation shifts to the alarming increase in AMR, a situation where bacteria evolve to resist the effects of antibiotics, rendering these life-saving drugs ineffective.

Dominic Hughes:
"Antimicrobials, antibiotics are becoming less effective. Instead, we're seeing the emergence of what are called superbugs."
(10:02)

Jonny Diamond explains the mechanisms behind AMR, emphasizing both natural evolutionary processes and the misuse or overuse of antibiotics as primary drivers.

Jonny Diamond:
"Antibiotics are used to treat or prevent a really big range of bacterial infections... global antibiotic consumption rates since they were introduced have just gone through the roof."
(08:23)

He highlights the stagnation in new antibiotic development since the late 1980s, a trend that has significantly contributed to the current AMR crisis.

War as an Accelerant for AMR: The Case of Ukraine

The episode delves into how ongoing conflicts, particularly the Russian invasion of Ukraine, are intensifying the AMR problem. Abdul Jalil Abdul Rasulov reports firsthand from Ukrainian hospitals overwhelmed by war casualties.

Abdul Jalil Abdul Rasulov:
"Private Bezverni had resistance to antibiotics... when they arrive at hospital, they get some sort of antibiotics and then the treatment procedure gets disrupted."
(16:50)

Patients like Private Osanda Biswerkni suffer severe injuries compounded by multi-resistant infections, largely due to disrupted treatment protocols and overcrowded, understaffed hospitals unable to maintain sterile environments.

Jonny Diamond:
"It's estimated that penicillin reduced the mortality rate from bacterial infections among wounded soldiers by 15%... a new dark age of drug resistance looms."
(12:11)

The report underscores the dire situation where the battlefield's massive antibiotic use is breeding superbugs, undermining decades of medical progress.

War's Impact on AMR in Gaza

Expanding the scope, the podcast examines similar patterns in Gaza, where conflicts have led to soaring rates of antibiotic-resistant infections.

Abdul Jalil Abdul Rasulov:
"MSF treated almost twice the number of patients it had the previous year in Gaza, reaching around 8,000 people."
(20:05)

He details how fragile health systems, environmental contamination, and the intermingling of civilians with combatants exacerbate the spread of AMR. Hospitals often become sites of infection rather than healing, with over 80% of admitted patients in Kyiv facing multi-resistant infections.

Jonny Diamond:
"In conflict-affected regions, you've got this sort of pretty fragile health system to start with... it's highly likely that AMR rates have gone up."
(20:34)

Global Implications and Responses

The discussion broadens to the global ramifications of AMR, emphasizing that it is not confined to war zones but is a universal threat requiring coordinated international action.

Jonny Diamond:
"It's a properly global problem. It affects high, medium, low-income countries across the world... One country just can't take it on alone."
(25:50)

The World Health Organization's initiatives to combat AMR are mentioned, including boosting research into new antibiotics and reducing global death rates from AMR by 10% by 2030 against the 2019 baseline.

Jonny Diamond:
"There has been this acknowledgement of the significant gaps in addressing AMR in what it calls humanitarian and low-resource settings."
(27:10)

However, challenges remain in translating these commitments into tangible actions, especially in resource-strapped and conflict-ridden regions.

Conclusion

The episode wraps up by reaffirming the critical nature of AMR as a global health emergency, exacerbated by the chaos of war. With projections estimating up to 10 million deaths annually by 2050 due to AMR, the need for sustained, global efforts to mitigate this threat has never been more urgent.

Dominic Hughes:
"These antimicrobial medicines, they're the cornerstone of modern medicine. Drug-resistant bacteria threaten to undermine all of that."
(13:52)

The podcast concludes with a call to action for responsible antibiotic use, adherence to international humanitarian laws in conflict zones, and the necessity of global cooperation to address the AMR crisis effectively.

Notable Quotes:

• Dominic Hughes
  "A new dark age of drug resistance looms as antimicrobial drugs are prescribed in massive quantities on the battlefield and to civilian casualties."
  (01:36)

• Jonny Diamond
  "Antimicrobial medicines, they're the cornerstone of modern medicine. Drug-resistant bacteria threatens to undermine all of that."
  (13:52)

• Abdul Jalil Abdul Rasulov
  "Private Bezverny had resistance to antibiotics... he had sepsis five times and doctors operated on him more than 100 times."
  (19:16)

This episode of the Global News Podcast provides a comprehensive exploration of the intertwined issues of antimicrobial resistance and global conflict, highlighting the urgent need for coordinated efforts to safeguard humanity's medical advancements.