By 2050, drug-resistant infections could cause global economic damage on par with 2008 financial crisis

The World Bank



New research from World Bank shows that antimicrobial resistance would increase poverty and affect poorest countries the most

NEW YORK, September 19, 2016—Drug-resistant infections have the potential to cause a level of economic damage similar to—and likely worse than—that caused by the 2008 financial crisis, according to a new report by the World Bank Group entitled “Drug Resistant Infections: A Threat to Our Economic Future.” The research shows that a high-case scenario of antimicrobial resistance (AMR)—where antibiotics and other antimicrobial dugs no longer treat infections the way they are supposed to—could cause low-income countries to lose more than 5% of their GDP and push up to 28 million people, mostly in developing countries, into poverty by 2050. And unlike the financial crisis of 2008, there would be no prospects for a cyclical recovery in the medium term, as the costly impact of AMR would persist.

“The scale and nature of this economic threat could wipe out hard-fought development gains and take us away from our goals of ending extreme poverty and boosting shared prosperity,” said Jim Yong Kim, President of the World Bank Group. “The cost of inaction is unaffordable—especially for the poorest countries. We must urgently change course to avert this potential crisis.”

Key findings of the report are based on World Bank Group projections of the world economy in 2017-2050. They include:

• Impact on GDP: By 2050, annual global GDP would fall by 1.1% in the low-impact AMR scenario and 3.8% in the high-impact AMR scenario. Low-income countries would lose more every year leading up to 2050, with the loss exceeding 5% of GDP in 2050 in the latter scenario.
• Impact on global poverty: There would be a pronounced increase in extreme poverty because of AMR. Of the additional 28.3 million people falling into extreme poverty in 2050 in the high-impact AMR scenario, the vast majority (26.2 million) would live in low-income countries. Currently, the world is broadly on track to eliminate extreme poverty (at $1.90/day) by 2030, reaching close to the target of less than 3% of people living in extreme poverty. AMR risks putting this target out of reach.
• Impact on world trade: In 2050, the volume of global real exports would shrink by 1.1% in the low-case scenario, and by 3.8% in the high-case scenario.
• Impact on healthcare costs: Global increases in healthcare costs may range from $300 billion to more than $1 trillion per year by 2050.
• Impact on livestock output: By 2050, the decline in global livestock production could range from a low of 2.6% to a high of 7.5% per year.

Drug-resistant infections, in both humans and animals, are on the rise globally. If AMR spreads unchecked, many infectious diseases will again be untreatable, reversing a century of progress in public health. The United Nations has scheduled a day-long special session on AMR as part of the UN General Assembly in New York this week, only the fourth time that health is being highlighted in this way.

“We now know that—unless addressed swiftly and seriously and on a sustained basis—the growing global problem of antibiotic resistance will be disastrous for human and animal health, food production and global economies. The fact that, left unchecked, it would penalize the poor more than anyone, makes clear why this needs to be addressed as a critical issue for development. As heads of state come together at the UN General Assembly high-level meeting on antimicrobial resistance this week, this should be front of mind," said Margaret Chan, Director-General of the World Health Organization (WHO).



Several recent reports on AMR, including the most recent one by Lord Jim O’Neill’s independent policy review, have called for an urgent focus on this issue and highlighted the enormous global economic losses it can cause—it estimated about $100 trillion in total by 2050.

Lord Jim O’Neill, Chairman of the Review on Antimicrobial Resistance, said about today’s World Bank Group report: “This report provides another timely reminder that rising drug resistance is a looming threat to our prosperity and sustained economic development in all parts of the world. As global leaders meet at the UN this week, I hope that this report will help to harden their resolve to take proper, collaborative action on the many challenges of AMR.”

The report outlines the crises in the human and veterinary public health sectors and in the environment, where capacity for regulating antimicrobials is insufficient in many countries, where misuse and overuse of antibiotics is an issue for some while access remains difficult for many. There is insufficient investment in building strong public health systems, including surveillance and monitoring, that can reduce risk at the interface between humans, animals and their environment.

The report recommends both AMR-sensitive and AMR-specific solutions to address the crisis. It says that one of the best opportunities in the short-term to mitigate the threat of AMR is to strengthen investments in health systems and overall preparedness to tackle infectious diseases, and to improve public and veterinary health systems while building surveillance for AMR into them as an integral component. It strongly supports implementation and adequate financing of the WHO Action Plan on AMR, which was endorsed in 2015. It also recommends an urgent focus on innovative AMR-specific interventions that promote and incentivize better stewardship of antimicrobials both for humans and animals, including the appropriate use of antibiotics in animal husbandry.