Drug-Resistant Infections: A Threat to Our Economic Future. March 2017, Washington, DC: World Bank
(2017; 172 pages)

World Bank. 2017. “Drug-Resistant Infections: A Threat to Our Economic Future.” Washington, DC: World Bank. License: Creative Commons Attribution CC BY 3.0 IGO


This report examines the economic and development consequences of antimicrobial resistance (AMR)—the capacity that disease-causing microorganisms acquire to resist the drugs we’ve created to fight them. The report uses World Bank Group economic simulation tools to put a price tag on AMR’s destructive impacts on the global economy from 2017 through 2050, if adequate measures aren’t taken to contain the AMR threat.

The report highlights actions low- and middle-income countries and their development partners can take to counter AMR, and estimates the investment required. It shows that putting resources into AMR containment now is one of the highest-yield investments countries can make.

Without AMR containment, the Sustainable Development Goals for 2030—such as ending poverty, ending hunger, ensuring healthy lives, reducing inequality, and revitalizing global development partnerships—are less likely to be achieved.

The impacts of AMR on poverty are particularly concerning. In the high AMR-impact scenario, an additional 24 million people would be forced into extreme poverty by 2030. Most of the increase would occur in low-income countries. As a result, the World Bank Group goal of eliminating poverty by 2030 would be harder to reach.

WHO’s Global Action Plan on AMR (WHO 2015), developed in collaboration with the World Animal Health Organization (OIE) and the United Nations Food and Agriculture Organization (FAO), defines five broad objectives for the AMR fight. Building on the global plan, several recent landmark reports have provided additional guidance on national policies and implementation strategies to fight AMR. These publications include the final report from the U.K. Review on AMR (Review on Antimicrobial Resistance 2016) and global plans from OIE (2016) and FAO (2016). Together with the Global Action Plan, these sources have set forth a comprehensive high-level policy agenda for the AMR fight.

This also means that we don’t need to “reinvent the wheel” here. Our recommendations concentrate on select areas where opportunities for important advances exist, and where World Bank knowledge, experience, and resources can add value to the country efforts we propose.

To implement the Global Action Plan and in particular to understand how it will be financed, it is useful to analyze country options through a sectoral lens. Accordingly, our recommendations for country AMR action are structured by sector, including: (a) health; (b) agriculture; and (c) water, sanitation, and hygiene.

Driving AMR Progress from the Health Sector:
The health sector offers many entry points for AMR control. Our recommendations focus on three topics: (1) universal health coverage reforms as an enabling platform; (2) harnessing the International Health Regulations (IHRs) to accelerate AMR action; and (3) strengthening laboratory-based surveillance, including through regional networks.

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