The Hidden Pandemic that killed 1.3 million in 2019

It was predicted that antibiotic resistant bacteria will kill more people than cancer (10 million yearly) by 2050. But that may happen earlier, according to a study.

The latest study in the medical journal Lancet, concluded that in 2019, 4.95 million deaths were associated with drug-resistant bacterial infections, of which 1.27 million deaths were directly caused by antimicrobial resistance.

“Previous estimates had predicted 10 million annual deaths from antimicrobial resistance by 2050, but we now know for certain that we are already far closer to that figure than we thought,” says University of Washington health economist Chris Murray, who co-authored the new research.

If antibiotics lose their effectiveness, key medical procedures — including organ transplants, Caesarean sections, and hip and joint replacements — could become too dangerous to perform.

And continued misuse and overuse of antibiotics could, within a generation, see the global death toll from drug-resistant infections rise to 10 million — more than currently die of cancer.

In low- and middle-income countries, resistance is already high: In Indonesia, Brazil and Russia, up to 60% of bacterial infections are already resistant to at least one antibiotic.

In Malaysia, antibiotic-resistant bacteria are in our food, rivers and environment. It has spread to the community.

Antibiotics are used without proper oversight, resulting in their abuse.

Examples include when humans take antibiotics which are only effective against bacteria to fight infections caused by viruses (like the flu), or when humans start an antibiotic treatment but do not finish taking all the antibiotics.

Worse is when antibiotics are used as growth promoters in livestock. In 2017, the World Health Organisation (WHO) reported that as much as 80% of all antibiotics are used on farm animals.

The cumulative results of these actions are ineffective medicines and persistent, untreatable infections.

Do meats and aquatic products in Malaysia have antibiotic residues?  In May 2016, the United States Food and Drug Administration banned shrimp and prawns from Malaysia because they contained 2 banned antibiotics, chloramphenicol and nitrofurans.

Ironically, these 2 antibiotics have been banned for use in Malaysia since 1985. Yet they continue to pop up in our farmed fisheries — as well as farmed meat products.

In the late-1980s CAP’s investigations found commercial pig and poultry farms using chloramphenicol. In 2002, the Health Ministry Parliamentary Secretary revealed that nitrofuran and chloramphenicol had been found in chickens tested.

In November 2012, the Sarawak State Veterinary Authority banned the import of certain Ayamas processed food products into the state due to the detection of chloramphenicol in a sample of a chicken frankfurter.

CAP in its surveys have found the indiscriminate use of antibiotics in commercial poultry and pig farms and the sale of antibiotics in shops selling animal feeds. As recent as January 2016, CAP found the antibiotic erythromycin was widely available in shops selling animal feed in Kedah and Perlis.

In Malaysia, CAP’s tests on meats sold locally in the past have also indicated the presence of antibiotic-resistant bacteria.

In 1988, CAP’s tests found penicillin-resistant bacteria in chicken, mutton and pork. Several strains of bacteria were also resistant to neomycin and chloramphenicol. This shows the rampant use of antibiotics in Malaysian farms.

Our tests in 1995 found a majority of bacteria in many types of meat — chicken, beef, mutton and pork — were resistant to 2 types of antibiotics, ampicillin and amoxycyllin. This demonstrates the existence of food-poisoning supergerms that could not be treated with some medicines.

Malaysia has banned 6 antibiotics from being used on livestock. The 6 antibiotics are erythromycin, enrofloxacin, tetracycline, ceftiofur, tylosin, and fosfomycin. Earlier it had also banned colistin, a last resort antibiotic used for human beings.

But we do not know whether our meats are really free from these banned or other antibiotics as past experiences showed the despite bans, the antibiotics are still used. The Veterinary Department and the Health Ministry must reveal results from their surveillance and enforcement reports to the public.


The Consumers Association of Penang (CAP) calls on consumers, patients, healthcare providers — and the farming industry — to stop the creation of super-powered germs to help slow down the antibiotic-resistance pandemic.


To help fight antibiotic resistance and protect yourself against infection:

>  DON’T take antibiotics unless you really need them. For illnesses caused by viruses — common colds, bronchitis, and many ear and sinus infections — they won’t.

>  FINISH your pills. Take your entire prescription exactly as directed. Do it even if you start feeling better. If you stop before the infection is completely wiped out, those bacteria are more likely to become drug-resistant.

>  STAY safe in the hospital. Antibiotic-resistant bacteria are commonly found in hospitals. Make sure your caregivers wash their hands properly. Also, ask how to keep surgical wounds free of infection.

When Not to Take Antibiotics

There are 2 major types of germs that can make people sick: bacteria and viruses. And antibiotics do not work against viruses. 

Many bacteria are beneficial but some bacteria are harmful and can cause illness. Antibiotics are effective against bacteria because they work to kill these living organisms by stopping their growth and reproduction.

The body’s immune system can fight off some viruses before they cause illness, but others (colds, for example) must simply run their course.


Healthcare providers can greatly help prevent the spread of antibiotic resistance as doctors who over-prescribe antibiotics are a big part of the problem.

The US Centers for Disease Control (CDC) estimates that roughly 30% of antibiotics are over-prescribed in the US.


Farmers should stop using any antibiotics routinely to promote growth and prevent disease in animals that are otherwise healthy.

Around 130,000 tonnes of antibiotics are given to food animals annually, according to a 2017 analysis of global sales data.

This means the use of antibiotics in animals now outstrips that in humans.

Antibiotics used in agriculture can be ingested by humans through food consumption.  It is also estimated that up to 90% of antibiotics consumed by animals are excreted – releasing them into the natural environment for dispersal in ground and surface waters.


Press Statement / Letter to the Editor, 28 January 2022