“Embracing a One Health Framework to Fight Antimicrobial Resistance” Report

September 21, 2023

A new report from the Organisation for Economic Co-operation and Development (OECD) has shed light on the health and economic consequences of antimicrobial resistance (AMR). Titled “Embracing a One Health Framework to Fight Antimicrobial Resistance,” the report, released on September 14, 2023, provides fresh evidence of the global impact of AMR and offers recommendations to combat it. The report emphasizes that without a robust One Health action plan, AMR levels will remain unacceptably high, leading to thousands of deaths annually and increased pressure on healthcare systems.

What is antimicrobial resistance (AMR), and why is it considered a global public health issue?

AMR refers to the ability of bacteria, viruses, and other microbes to resist the effects of antimicrobial drugs like antibiotics. It is a global public health issue because the overuse and misuse of antibiotics in various sectors have led to growing resistance, rendering these drugs less effective. This can result in prolonged illnesses, increased healthcare costs, and even deaths when infections become untreatable.

How has the consumption of antibiotics in humans evolved, according to the OECD report?

The report indicates that the total consumption of antibiotics in humans has been increasing modestly across OECD and EU/EEA countries and significantly across G20 countries over the last two decades. However, it is projected to remain steady in OECD countries from 2015 to 2035. Meanwhile, consumption in EU/EEA and G20 countries could decline by 3.3% and 6.2%, respectively, by 2035.

What are some of the key findings regarding antibiotic resistance proportions?

The report reveals that resistance proportions for 12 priority antibiotic-bacteria combinations reached 20% in 2019, meaning that one in every five infections in OECD and EU/EEA countries is due to organisms resistant to antimicrobials. High resistance proportions, above 44%, were reported for India, Greece, and Türkiye (Turkey) in 2019, and this high resistance is expected to persist until 2035.

What are the health and economic impacts of AMR, as highlighted in the report?

AMR is reported to cause approximately 79,000 deaths annually, which is 2.4 times more than diseases such as influenza, tuberculosis, and AIDS in 34 OECD and EU/EEA countries. Infections are majorly found in individuals aged above 65. Three bacterial strains—Escherichia coli, Klebsiella pneumonia, and Staphylococcus aureus—are responsible for three-quarters of AMR-related deaths. Healthcare-acquired resistant infections account for about 60% of all deaths. Additionally, AMR leads to extended hospital stays, costing the health system approximately $28.9 billion annually up to 2050 across these countries.

What are some of the policy interventions recommended in the report to combat AMR?

The report emphasizes a One Health approach and outlines 11 policy interventions, including hospital-based and community-based plans that focus on areas such as hand hygiene, antimicrobial stewardship, and rapid diagnostic tests. The report also highlights measures outside human health, like food safety practices and biosecurity on farms, as essential to addressing AMR. These interventions can provide substantial benefits, including reductions in health expenditure and gains in workforce productivity.

How does the report assess the cost-effectiveness of policy interventions to combat AMR?

The report indicates that the return on investment for various policy measures to combat AMR ranges from 2.3 to 24.6. It underscores that the benefits and gains in health expenditure and workforce productivity are significantly higher than the costs of implementing these measures. The report also considers policy packages, including hospital-based, community-based, and mixed packages, with the potential to combat infections, reduce deaths, and generate cost savings.

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