Afghanistan
Resistance to drugs is on a dangerous and costly rise, reveals a new study by KPMG and RAND Europe, commissioned by the UK government. If not adequately tackled, the consequences in terms of economics and human life will be colossal, warn the researchers. Between now and 2050, 300 million people could die prematurely, leading to an expected loss of ~$100 trillion worth of economic output.
Anti-microbial resistance (AMR) occurs when a microorganism (bacteria, virus, fungus, parasites) evolve a way of mitigating the effect of our drugs to control them. While the chance of a microbe mutating in just the ways required for it to resist the antimicrobial therapy are tiny, when drugs are improperly administered or over proscribed to millions of individuals and animals, the microorganism may spontaneously develop resistance to that antibiotic agent. When a microorganism develops multiple resistance to many or all of our drug therapies, routine operations and treatments, from hip replacement to caesarean sections, become increasingly dangerous. Dangerous infections, such as Klebsiella pneumonia and Staphylococcus aureus, are already showing concerning resistance levels, leading to high mortality rates to those with active infections.
To shed light on government and healthcare policy in the field, the UK Prime Minister in July 2014 launched a large research programme (‘Review on Antimicrobial Resistance’), aimed at developing a clear package of actions that can be agreed, both locally and internationally, to stem and deal with AMR. To quantify the risk AMR has in the long term (until 2050), the Review commissioned two multidisciplinary research teams, one from accounting and consulting firm KPMG and the other from RAND Europe, to run the numbers. They each delivered a report, while their models differed in starting assumptions, both returned concerning long term trends with regard to the effects of AMR on human life*.
In KPMG’s case, the researchers outlined four possible futures which considered the effects of resistance in three bacteria, Staphylococcus aureus, Escherichia coli, and Klebsiella pneumonia, the HIV virus and Tuberculosis:
â– Scenario A - an absolute increase in current rates of resistance by 40%
â– Scenario B - 100% resistance rate applied across all countries
â– Scenario C - Doubling of current infection rates for the three bacteria, HIV and Tuberculosis, and an absolute rise in current rates of resistance by 40%
â– Scenario D - Doubling of current infection rates for the three bacteria, HIV and Tuberculosis, and 100% resistance rate in all countries
Scenario D is the most chilling, with 700 million deaths between now and 2050 attributed to AMR and a total economic loss to world GDP of $14,228 billion compared to the baseline in 2050. In scenario A the loss of life to AMR is modelled to be 200 million by 2050, with a GDP loss of around $500 billion. Yael Selfin, Head of Macroeconomics at KPMG and author of the KPMG report comments: “There has been increasing concern about the harm anti-microbial resistance (AMR) could cause to people and to the world economy, with AMR levels partially exacerbated by the overuse of antibiotics.”
GDP $60 to $100 trillion lower
Drawing from the combined studies, in the most likely outcome from the scenarios, 300 million people will die prematurely because of drug resistance over the next 35 years and the world’s GDP will be 2.0% to 3.5% lower than it otherwise would be in 2050. Ten million people will die per year by 2050 from AMR if no new therapies or preventative measures are taken, this death rate far surpasses the death rates for automotive accidents, at 1.2 million today, and surpasses cancers at 8.4 million deaths per year. Overall, this means that between now and 2050 the world can expect to lose between $60 and $100 trillion worth of economic output if antimicrobial drug resistance is not tackled. This is equivalent to the loss of around one year’s total global output over the period, and will create significant and widespread human suffering. Furthermore, in the nearer term the world’s GDP will be 0.5% smaller by 2020 and 1.4% smaller by 2030 with more than 100 million people having died prematurely.
The effect of AMR are likely to be the most heavily felt by those living in developing nations over those in developed nations, the analysis found. The hardest hit region is projected to be Africa, with a worst case scenario predicting a fall in GDP of $2.9 trillion in 2050, which represents 20% of the region’s total economic output.
“What we found was those who are more vulnerable are likely to pay the highest price,” says Yael, adding: “AMR represents a genuine cost to society and the potential loss from not addressing the AMR challenge cannot be seen as a potential economic loss in isolation. The rise in AMR and its capacity to cause real damage to society, and to the world economy, should encourage the development of new antibiotics, and increase efforts to ensure future social and economic impacts are minimised.”
* The aim of the scenarios was to map the economic consequences of AMR over time. The sociological and secondary effects of resistance were not considered.
