One in every five infections in OECD and EU/EEA countries are due to organisms resistant to antimicrobials
The report predicted that without action, resistance to third line antibiotics could double in 2035 than it was in 2005. Photo: iStock A new report providing fresh evidence on the health and economic costs of antimicrobial resistance (AMR) was released by the Organisation for Economic Co-operation and Development (OECD).
Embracing a One Health Framework to Fight Antimicrobial Resistance, released September 14, 2023 also gave necessary recommendations to combat AMR. The report built on the statistics from OECD, European Union (EU) and European Economic Area (EEA) countries and Group of 20 (G20) countries.
AMR is accepted as a global public health issue, leading to a silent pandemic due to the overuse and misuse of antibiotics in different sectors. It is resulting in antibiotic inefficacy and growing resistance of bacteria to antibiotics.
Without a strong One Health action plan, AMR levels will continue to be unacceptably high and may lead to thousands of deaths every year in the OECD and EU/EEA and G20 countries, the report said. This could result in extended hospitalisations and thus, increased pressure on healthcare systems.
The total consumption of antibiotics in humans has been increasing for the last two decades, modestly across OECD and EU/EAA countries and quite substantially across G20 countries, according to the report. However, it is suspected to remain steady in humans in OECD countries between 2015 and 2035.
Among EU/EEA and G20 countries, the total consumption could decline to 3.3 per cent and 6.2 per cent, respectively. At present, it is 20 per cent in OECD countries, 22 per cent in the EU/EEA and 30 per cent in the G20 countries.
Consumption of last resort antibiotics, for example, polymyxins, has increased faster as compared to the total consumption, the OECD said. On the other hand, the average sales of all classes of antibiotics has declined globally in the last two decades (2000-2019) and halved in OECD countries from 181 to 91 milligramme of antimicrobials per kilogramme of food animal.
Antimicrobial consumption in animals may fall by 10 per cent in OECD countries between 2020 and 2035, further estimations suggested. By 2035, the sale of veterinary antimicrobials in G20 countries could nearly double that of the sales in OECD countries.
The resistant proportions for 12 priority antibiotic-bacteria combinations stood at 20 per cent in 2019, meaning that one in every five infections in OECD and EU/EEA are due to organisms resistant to antimicrobials.
The report predicted that without action, resistance to third line antibiotics could double in 2035 than it was in 2005. The trend analysis of AMR showed that resistance proportions were above 44 per cent in 2019 for India, Greece and Türkiye, and estimated to remain high till 2035.
It also mentioned that 90 per cent of infection can be resistant to antibiotics, like fluoroquinolone-resistant and carbapenem-resistant A Baumanii in the countries with high resistance proportions.
Each year, AMR is reported to cause deaths of around 79,000 people, which is 2.4 times more than diseases such as influenza, tuberculosis and acquired immunodeficiency syndrome or AIDS in 34 OECD, and EU/EEA countries.
In addition, more than 4.3 million infections have been reported and majorly found in humans aged above 65.
Three out of four AMR-related deaths are mainly caused by three bacterial strains — Escherichia coli, Klebsiella pneumonia and Staphylococcus aureus. These are responsible for one in three resistant infections.
Healthcare-acquired resistant infections constitute about one third of all resistant infections and account for 60 per cent of all deaths
Every year around 32.5 million additional days are spent in hospital due to resistant infections, which is as high as the entire acute bed capacity in a small country like Spain, the report pointed out. Ultimately, it is causing a huge cost to the health system as suspected to be around $28.9 billion each year up to 2050 for 34 OECD and EU/EEA countries.
The total annual cost of AMR across 34 OECD and EU/EAA countries is around $58 per capita, one third of which are due to increased health expenditure, while remaining is due to reduction in productivity of workforce.
Out of total 51 OECD, EU/EEA and G20 countries, 47 have national action plans but only 10 countries have incorporated financial provision among these, the report further highlighted.
The report emphasised tackling AMR by considering 11 one health policy interventions.
11 health policies to combat AMR
Source: OECD
These include hospital-based intervention plans focusing on hand hygiene, environmental hygiene, scaling up antimicrobial stewardship plans.
The second intervention area is community based, which includes delayed antibiotics prescription, financial incentives to regularise the antibiotics usage, scaling up the use of rapid diagnostic tests, scaling up mass media campaigns and scaling up prescriber training.
It also focuses on two policies outside human health — better food safety practices and improved biosecurity in farms.
For most interventions in the area of human health and food safety, the benefits and gains made in health expenditure and productivity of the workforce is much more than the costs of implementing these measures. The return on investment ratio ranges from 2.3-24.6 in case of different policy measures.
OECD also considered three policy packages that include a hospital-based package, a community-based package and a mixed package.
The mixed health packages include hand hygiene, scaling up antimicrobials stewardship programmes, delayed antimicrobial prescription, increasing the mass media campaigns, biosecurity of farms and enhancing the food handling practices.
The investment in the mixed policy packages could combat more than 1.6 million infections every year and approximately 17,000 deaths and saves costs in the health expenditure and altogether gains through involvement of workforce and productivity in 34 countries.
The annual average cost of implementing the mixed package is around five times lower than the reduction in health expenditure and productivity gains combined
We are a voice to you; you have been a support to us. Together we build journalism that is independent, credible and fearless. You can further help us by making a donation. This will mean a lot for our ability to bring you news, perspectives and analysis from the ground so that we can make change together.
.png)
Comments are moderated and will be published only after the site moderator’s approval. Please use a genuine email ID and provide your name. Selected comments may also be used in the ‘Letters’ section of the Down To Earth print edition.