Antimicrobial resistance (AMR) poses a real threat to vulnerable groups in developing countries. Low-income groups and populations living below the poverty line are disproportionately affected. Global research published in The Lancet expects AMR to cause 39 million deaths annually between 2025 and 2050.

The economic effects may cause significant losses globally. As the World Bank reported, by 2050 AMR is expected to lower the global gross domestic product (GDP) by around 3.8% annually, with 28 million people potentially slipping into poverty.

In biotechnology, nanotechnology promises new avenues for tackling superbugs in high-risk countries such as Brazil and India. By specifically targeting infections, nanoparticles can bypass resistance. This approach can reduce medication costs for low-income populations, positively affecting economic development.

Health Crisis in India and Brazil

India and Brazil are among the G20 countries with the highest proportion of people living below the extreme poverty line. Antibiotic resistance is disproportionately high among these populations. According to the Institute for Health Metrics and Evaluation, antibiotic resistance in India has caused 300,000 deaths annually since 1990, placing the country among those with the highest numbers.

In Brazil, approximately 32,000 deaths each year are attributed to antibiotic resistance, the highest rate among Latin American countries. The situation in both countries places enormous strain on their health care systems. Experts believe antibiotic resistance could trigger a serious health crisis, accompanied by rising public costs and a decline in GDP. For Brazil, the World Bank estimated a loss of 4.4% to 5.1%.

Poor hygiene standards, high settlement density, particularly in slums, contaminated water, and a lack of access to adequate medical care and infrastructure put people living in poverty at a higher risk of developing antibiotic resistance than those with higher incomes.

The situation worsens with the misuse of antibiotics. Individuals from low-income groups often take underdosed medications due to financial difficulties. Additionally, they share drugs with family or neighbors, resulting in insufficient doses. This allows stronger bacteria to survive and multiply with more resistance.

Furthermore, regulations in many regions encourage the misuse of antibiotics. Vendors often sell these medications over the counter as substandard or counterfeit products. This market promotes the growth of resistant bacteria and accelerates their spread.

Nanotechnology in India and Brazil

To counter the threat of antibiotic resistance in Brazil and India, cost-effective nanoparticles may provide promising solutions. Materials are used on a very small scale, allowing them to develop unique properties. Nanotechnology is used either as an antibiotic itself or as a carrier for antimicrobial agents to combat infections more effectively.

Nanoparticles, classified into metallic, organic, carbon-based, and hybrid systems, can bypass mechanisms of antibiotic resistance. Their mode of action resembles a Trojan horse: transporting and protecting the antibiotic, they smuggle the active ingredient into the infected cell. Additionally, they can destroy biofilms, slime layers formed by resistant bacteria, penetrating the pathogen and damaging its proteins, enzymes and DNA.

Although India and Brazil lead in nanoparticle research, they face challenges in implementing nanotechnology to tackle superbugs in their health care systems. Besides concerns about environmental and biological risks, which require further research, developing countries face financial hurdles. Insufficient production capacity, supply chain difficulties and regulatory barriers hinder the fight against antibiotic resistance, trapping people below the poverty line in a cycle of illness and financial hardship.

Research and Development of Nanotechnology

Nonprofit organizations such as the India AMR Innovation Hub (IAIH) aim to tackle superbugs by providing financial support to biotech startups and fostering scientific collaboration. For example, the startup Module Innovations developed an ultra-fast diagnostic method using “Size Dependent Signal Amplification of Nanoparticles” (SDSAN). This method can detect urinary tract infections within 15 minutes. Over the next five years, the India AMR Innovation Hub plans to move 10 to 15 biotechnology projects, including nanotechnology initiatives, from the laboratory stage to the development phase.

The Brazilian National Nanotechnology Laboratory (LNNano) provides facilities and technical and scientific support for research into the effects of nanomaterials on biological systems and the environment. The development of nano-based drug delivery systems and nanoparticles with modified surfaces makes the fight against drug-resistant bacteria 10 times more effective.

Looking Ahead

To reduce the negative global impacts of antibiotic resistance in heavily affected countries such as India and Brazil, international development aid and policy initiatives are crucial for improving the health of people living in extreme poverty. By promoting the development of appropriate infrastructure for production and distribution and supporting governments in establishing regulatory frameworks, nanotechnologies in India’s and Brazil’s health care systems could create millions of jobs worldwide and boost global GDP. Moreover, millions of lives can be saved.

– Oliwia Kowalak

Oliwia is based in Berlin, Germany and focuses on Technology and Solutions for The Borgen Project.

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