Failure to address growing resistance to antibiotics and other drugs will lead to the deaths of an additional 10 million people each year worldwide by 2050 and cost the global economy up to US$100tn, projects the first UK report by the Review on Antimicrobial resistance.
The review, which was commissioned in July 2014 by UK Prime Minister David Cameron to look at the dangers posed by drug-resistant superbugs, has been tasked with providing an action list of recommendations for the international community to tackle growing antimicrobial resistance (AMR) by the summer of 2016. The review is chaired by economist Jim O’Neill.
Unless the international community takes action, 10 million more people will die each year from drug-resistant infections by 2050, according to the report, ‘Antimicrobial resistance: tackling a crisis for the health and wealth of nations’, which was produced by RAND and KPMG with input from experts in the scientific community.
The additional number of deaths would cost the global economy between US$60tn and US$100tn from now until 2050 through a reduction of 2–3.5% in Gross Domestic Product (GDP), as the world would be producing less.
The projected number of additional deaths is likely to be an underestimate because the review’s predictions are based on the impact of AMR on only a subset of drug-resistant bacteria and public health issues — Klebsiella pneumonia, Escherichia coli, Staphylococcus aureus, HIV, tuberculosis (TB) and malaria.
The economic consequences are also underestimated. “The research was commissioned to understand the economic cost of AMR, interpreted strictly as its impact on global GDP. Other issues, such as social and healthcare costs, were not considered,” the report adds. “If AMR continues to grow as a major problem in the world it will have enormous consequences for how we deliver healthcare.”
In particular, medical procedures now considered routine will become far more dangerous because of a higher risk of infections. “Many procedures, such as hip operations, which currently allow people to live active lives for longer and may enable them to stay in the workforce, might become too risky to undertake,” the report says. “Modern cancer treatments often suppress patients’ immune systems, making them more susceptible to infections. Therefore, without effective antibiotics to prevent or treat infection, chemotherapy would become a much riskier proposition.”
Few published studies have attempted to predict how many more people will get infections when prophylactic antibiotics do not work, so the review also attempted to estimate the economic value created for society of four high-volume routine medical interventions that are dependent on the availability of effective antibiotics to make them comparatively low-risk. “We attempted to factor in the secondary effects of antibiotics not working,” a spokesperson for the review says. They calculated that Caesarean sections contribute around 2% to world GDP, joint replacements add around 0.65%, cancer drugs contribute more than 0.75% and organ transplants add about 0.1%. In total, just these four interventions contribute almost 4% to the world’s GDP. When combined with the other effects of AMR, this means the world’s economy could lose more than 7% of its GDP by 2050 (US$210tn).
Dame Sally Davies, the chief medical officer for England, described the report as “a compelling piece of work, which takes us a step forward in understanding the true gravity of the threat” of AMR. “It demonstrates that the world simply cannot afford not to take action to tackle the alarming rise in resistance to antibiotics and other antimicrobial drugs that we are witnessing at the moment.”
Jin-Yong Cai, CEO of International Finance Corporation, part of the World Bank Group and the largest global development institution focused on private sector development, said: “This report raises in stark terms the economic and human toll that AMR is taking on global health, and the consequences of inaction. As a financial development institution, we are concerned that AMR may constrain economic progress in the world’s poorest countries.”
The report highlights that countries which already have high malaria, HIV or TB rates are likely to see the greatest number of additional deaths as resistance to current treatments increases. These include India, Nigeria and Indonesia (malaria), Russia (TB) and countries in Africa (malaria and HIV).