Antibiotics have revolutionised modern medicine, turning once-fatal infections into manageable conditions. But the rise of bacteria resistant to these drugs threatens to undo decades of progress. In the European Union alone, antimicrobial resistance (AMR) is estimated to cause 35,000 deaths annually, a toll comparable to influenza, tuberculosis, and HIV/AIDS combined.
Fiona Walsh, a professor at Maynooth University in Ireland, studies how resistance spreads across human, animal, and environmental health. She explains that antibiotic resistance occurs when bacteria can no longer be treated with the medicines typically used against them. For patients infected with multidrug-resistant bacteria, the consequences can be severe. Doctors may resort to combining several antibiotics, but in some cases, even these combinations fail. "Unfortunately, some people will die," Walsh said.
The outlook is worsening. A study published in The Lancet projects that bacterial AMR could directly cause 39 million deaths worldwide between 2025 and 2050. The drivers are well known: overuse of antibiotics in humans, their widespread use in livestock, poor sanitation, and environmental pollution. Bacteria and the genetic material that confers resistance can move between humans, animals, and the environment, making the problem inherently cross-border.
A One Health approach
Researchers increasingly advocate a One Health approach, recognising that human health cannot be separated from animal and environmental health. This perspective is gaining traction in European institutions, where policymakers are under pressure to act. The European Commission has already adopted an action plan, but experts argue that more coordinated efforts are needed across the 27 member states and beyond.
Walsh is optimistic about the range of solutions. "The nice thing is that there are many different ways to kill bacteria and these bugs," she said. "There are also ways to protect ourselves." Vaccines, for instance, can reduce infections and thus the need for antibiotics. The World Health Organization estimates that better vaccine use could cut global antibiotic consumption by 2.5 billion doses annually.
Maintaining good health is equally important, especially for older people and those with weakened immune systems. "Staying healthy is really, really important," Walsh said, as it reduces the likelihood of developing infections that require antibiotic treatment. She also highlighted the role of our own microbiome: "Bacteria will also fight bacteria and if we have our own bacterial system within our body that's really healthy, then they can help fight infection as well."
Walsh stressed that bacteria are essential to life. "We need bacteria in order to live. We need them in our gut. We need it on our skin. We have them in your mouth. They're really important," she said, warning that excessive antibiotic and disinfectant use can disrupt the body's natural defences.
The challenge is not just medical but also political. As Europe grapples with security threats and economic pressures, AMR risks being deprioritised. Yet the human and economic costs are staggering. A 2023 report by the OECD estimated that AMR could cost EU healthcare systems billions of euros annually if left unchecked.
Some European countries are already taking bold steps. France has restricted antibiotic prescriptions, while the Netherlands has drastically reduced antibiotic use in livestock. But the problem is global, and resistance knows no borders. International cooperation, including with the UK, Switzerland, and the Balkans, is essential.
For now, the message from researchers like Walsh is clear: the fight against superbugs requires a holistic, Europe-wide strategy that addresses human behaviour, agricultural practices, and environmental stewardship. As she put it, "There are many different ways to kill bacteria," but the most effective may be to prevent infections in the first place.
