18 September 2016: The World Bank has released a draft report examining the economic and development consequences of antimicrobial resistance (AMR). The report finds that drug-resistant infections could cause economic damage ranging from 1.1% of global gross domestic product (GDP) in a low impact scenario, and up to 3.5% of global GDP in a high impact scenario, with middle- and low- income countries losing up to 5% of GDP.

Released on the eve of the UN General Assembly (UNGA) High-level Meeting on Antimicrobial Resistance, the draft report titled, ‘Drug-resistant Infections: A Threat to Our Economic Future,’ provides an overview of AMR evidence and its economic consequences in order to raise awareness among policy makers of the importance of minimizing and containing anthropocentric AMR for human health and economic development. The report shows that without AMR containment, several Sustainable Development Goals (SDGs) are unlikely to be achieved, in particular: SDG 1 (end poverty in all forms everywhere); SDG 2 (end hunger, achieve food security and improved nutrition and promote sustainable agriculture); SDG 3 (ensure healthy lives and promote well-being for all at all ages); and SDG 10 (reduce inequality within and among countries).

The first part of the report introduces the challenges of AMR. It describes AMR as a “tragedy of the commons” caused by incentives to overuse antibiotics in health care, farming and aquaculture, even though these practices will ultimately leave the global community worse off than in a scenario where the use of antibiotics is reduced and conserved. The section provides an overview of drug-resistant infections that are already common around the globe, and explains that containing AMR is a global public good. It also discusses the need to improve access to effective antibiotics in developing countries while closing the gaps in governance to prevent their overuse.

The second part of the report performs a number of simulations to analyze the impacts of AMR on the global economy, including impacts on international trade, livestock production, health care expenditures and poverty.

Part three discusses necessary measures to contain AMR with regard to: international cooperation; achieving expert consensus on AMR containment measures; ensuring support for human and veterinary public health systems, sustainable and predictable financing for AMR containment, and the adoption of One Health approaches; and examples of implementation approaches.

The remaining parts cover the status and methods of laboratory-based surveillance of AMR and case studies of antimicrobial use in human health care and AMR.

The report’s conclusions highlight the substantial costs of inaction on AMR even under an optimistic “low-AMR impact scenario” and stress the need for increasing investments in AMR containment and ensuring funding and technical cooperation to address AMR challenges.

With regard to the specific challenges of low and middle income countries, the report recommends: substantial and sustainable support for surveillance systems for veterinary and human health, including monitoring of such systems; pilot interventions and research to support more judicious use of antibiotics in humans and animals; and interventions to adapt food production systems, in particular livestock production, to a significantly reduced use of antibiotics.

Several Annexes provide additional information and resources on AMR, such as: potential savings from using One Health Approaches; Targets for SDG 3; an example budget of AMR surveillance; and national, regional and international AMR surveillance networks. [World Bank Press Release] [Publication: Drug-resistant Infections: A Threat to Our Economic Future (discussion draft)] [IISD RS Coverage of AMR] [IISD RS Story on FAO Action Plan on AMR] [IISD RS Story on Draft Outcome on AMR] [Draft Political Declaration]