Antibiotic resistance highest in poorer countries, research shows

A research conducted by the Centre for Disease Dynamics, Economics & Policy finds a strong correlation between a country’s income level and antimicrobial resistance


The study points that resistance to antimicrobials leads to huge health costs as well as higher rates of mortality.  Photo: Ramesh Pathania/Mint
The study points that resistance to antimicrobials leads to huge health costs as well as higher rates of mortality. Photo: Ramesh Pathania/Mint

New Delhi: A recent study reveals that countries with low national income has higher levels of antimicrobial resistance. The research conducted by the Centre for Disease Dynamics, Economics & Policy (CDDEP) finds a strong correlation between a country’s income level and antimicrobial resistance. Antimicrobial resistance (AMR) is the ability of a micro-organism (like bacteria, viruses) to stop an antimicrobial such as antibiotics from working against it.

The study conducted by CDDEP researchers highlights an urgent need for countries with low-income level to address the prevalence of AMR. The findings show that AMR levels are highest in the poorest countries.

“Poor environmental sanitation, poor infection control practices and lack of stewardship programs in healthcare facilities in low-income countries are the major contributors,” said Sumanth Gandra, scholar at CDDEP. The burden of bacteria is higher in the lower and middle income countries due to lack of sanitation conditions. This further results in the higher prevalence of AMR. He added that there is an urgent necessity to implement policies and programs to address AMR, particularly in resource-poor settings.

The study assessed the association between the gross national income per capita (GNIPC) of a country and level of AMR of three common pathogens causing infections in hospitals and the community. The research was conducted for 2013-14, across 45 countries divided into high, upper-middle and lower middle income economies.

The model predicted AMR prevalence of 12% in high-income countries, 31% in upper-middle income countries and 78% in lower-middle income countries.

The study points that resistance to antimicrobials leads to huge health costs as well as higher rates of mortality. This is because effective antibiotics with AMR are more expensive and thus, unaffordable by a major proportion of people living in their resource limited environment. It also leads to higher resistance to last resort antibiotics.

The study cites various reports and papers explaining reasons for transmission of antimicrobial resistance. It mainly occurs from contact with animals, other human beings and the environment. This is facilitated by factors which are prevalent in the low and middle income countries including high population density, lack of access to clean water, suboptimal sewage systems, poor sanitation and poor healthcare infection control practices. Lack of regulation on antimicrobial use in farming and pharmaceutical industry pollution are other important reasons identified by the study.

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