Superbugs and antibiotic resistance need combating to prevent a massive problem for humanity that could result in "devastating loss of life", University of Newcastle Professor Peter Lewis says.
A global effort similar to the development of COVID-19 vaccines is required, but faces challenges.
"The development of COVID-19 vaccines has been an amazing scientific effort that has astonished all of us," Professor Lewis said.
It showed how humanity can "come together for the greater good to solve life-threatening problems".
"COVID-19 was a new viral infection for which we have no intrinsic resistance, so if you caught it there was a significant chance it could make you very sick or even kill you. This was incredibly alarming for all of us and this type of acute situation tends to focus the mind."
Antibiotic resistance, he says, is "a bit more sneaky".
"We have lived with bacterial infections for millennia and they are part of our life experience," he said.
"We are used to being able to take a pill and recover from any infection we get. But as resistance increases, those drugs become less and less effective. One day they won't work any more."
Professor Lewis said the problem "affects all of us now, even in the Hunter Region".
"There is antibiotic resistance in the Hunter," he said.
"But it is important to remember that we have excellent health facilities and, in most cases, physicians have options for treatment of an infection if it does happen to be antibiotic-resistant."
He said the sneaky nature of rising antibiotic resistance made it "difficult to generate the same type of desire [as COVID] within society to devote resources to its fight".
Professor Lewis said it was "very simple to blame the pharmaceutical industry for failing to keep pace with resistance, but the reality is far more complicated".
"Developing new drugs is an incredibly expensive process that often takes many years. Despite our success with COVID-19 vaccines, this will still remain the case for most drugs.
"When drugs are being developed they have to go through an enormous number of tests to make sure they will work as they should without harming us."
The antibiotics problem requires billions of dollars of investment that the pharmaceutical company "needs to recoup if it is going to be able to continue to do business and develop more new drugs".
"The problem with antibiotics is that we only take them for a short time and don't expect to pay much for them, certainly no more than a standard prescription price.
"This makes antibiotic development very unattractive for a commercial company as it is incredibly hard to recoup the initial investment, let alone make any profit."
For some years, pharmaceutical companies have been working with non-profit and government organisations to develop platforms that promote new antibiotic development, without forcing a company into bankruptcy risk.
The Review on Antimicrobial Resistance commissioned by the UK government estimated in 2016 that, by 2050, 10 million lives a year and US$100 trillion of economic output worldwide were "at risk due to the rise of drug-resistant infections".
Immediate solutions were needed to "slow down the rise of drug resistance".
"Even today, 700,000 people die of resistant infections every year," the review said.
Professor Lewis said antibiotic resistance had become a big problem due to improper use of the drugs.
"If we get sick and go to a doctor, we will often expect or even demand a prescription that may well be for antibiotics even if we don't have an infection," he said.
"If we take those antibiotics then we are acclimatising the bacteria in our body to these drugs. When we do really have an infection, it might now be resistant to the antibiotic we're given."
An additional problem occurs in countries with poor regulation of industrial waste disposal. Antibiotics are dumped into water with the waste.
"This exposes all the bacteria in the environment to the antibiotic and encourages the development of resistance. This can be passed onto bacteria that cause infections, leading to the rise of antibiotic resistance."
The problem has been addressed to varying degrees.
"Good data shows that in countries where antibiotic use is very carefully monitored, and they are only used when absolutely necessary, levels of resistance are low.
"Unfortunately, Australia is around the middle of this ladder of responsible use."
A superbug is a bacterial infection in which the bug causing the infection has resistance to one or more antibiotics.
"Quite often, if an infection is resistant to one antibiotic [such as penicillin], it will also be resistant to others [such as erythromycin].
"In rare cases, the bug will be resistant to most or all the drugs a doctor has access to. This is what is most alarming."
The Bill & Melinda Gates Foundation recognised this in tuberculosis [TB]. "Whilst this is not a problem disease in Australia, it claims millions of lives worldwide and is endemic close to the northern tip of Australia," Professor Lewis said.
The bug that causes TB has, in many countries, multi-drug resistance or extreme drug resistance.
"Drug-resistant TB could cause a pandemic. Even in the 19th and 20th centuries in Europe, there were sanitariums and isolated hospital wards for TB patients."
The black death - also known as the plague - is an infection caused by a bacterium called Yersinia pestis.
"Around 30 per cent of the European population was thought to have perished due to the black death. It is estimated that it took more than 200 years for the European economy to recover.
"Plague is still present in some countries and we should never assume we are totally safe from the recurrence of a past pandemic species or the emergence of a new one."
Health systems are much better now and "we do have science on our side to help discover new treatments".
"But the list of available drugs is getting progressively smaller for many infections. In a few cases, there are no longer any drugs that can treat an infection - total antibiotic resistance. If we don't invest in the science, we will severely limit our ability to do anything about these problems in the future."
