Drug-resistant infections linked to $3.5 trillion in global economic losses in 2021
Chris Dall, MAToday at 11:44 a.m.
Antimicrobial Stewardship
New research highlights the economic toll of antimicrobial resistance (AMR) and the regions where that impact is most heavily felt.
In a study presented this week at the IDWeek 2026 conference in Washington, DC, a team of Indian and US researchers estimated that AMR was linked to $3.5 trillion in economic losses worldwide in 2021. Of that amount, $835 billion in economic loss was directly caused by infections with drug-resistant bacteria—roughly $106 for every person on earth.
“That would not have happened if the same infection had responded to standard antibiotics,” study author Hardik Desai, MBBS, a public health researcher at AB Plus Multispecialty Hospital in Ahmedabad, India, said at a press briefing last week. Desai co-led the study with Digantkumar Patel, MD, a hospitalist at Springfield Clinic in Illinois.
Desai said that the human toll of AMR is already well-documented. The Global Research on Antimicrobial Resistance study has estimated that drug-resistant infections directly caused 1.27 million deaths in 2019 and could take more than 39 million lives by 2050 if left unchecked.
He and Patel wanted to ask a different question, using language that budget makers might understand.
“We already know that resistance kills more than a million people a year,” Desai said. “But deaths alone don’t move finance ministers.”
The economic impact of healthy life years lost
The findings are based on an analysis of 2021 Global Burden of Disease data on disability-adjusted life years (DALYs) from drug-resistant infections, combined with World Bank gross domestic product (GDP) and population data.DALYs represent the number of healthy life years lost because of illness, disability, or early death. The data were applied to a framework—value of lost welfare (VLW)—that estimates economic losses associated with DALYs.
The analysis focused on the impact of 12 infectious syndromes and 22 bacterial pathogens in 21 regions of the world.
Overall, the researchers estimated there were 42.6 million DALYs in 2021 directly attributable to AMR, and 177.7 million that were associated with drug-resistant infections—meaning those infections contributed to disability, illness, or early death. That equated to a VLW of $3.5 trillion, or 2.25% of global GDP. But that amount is not simply the cash loss to an economy, Desai explained.
“It is a value of human life…a measure of human loss expressed in money so that it can sit next to other spending decisions,” he said.
The largest dollar losses were in South Asia ($101 billion), East Asia ($82 billion), and North America, including the United States and Canada ($70 billion).
But countries in Western and Eastern sub-Saharan Africa suffered the greatest proportional impact, with economic losses accounting for 1.42% and 0.96%, respectively, of their GDP.
The biggest contributors were bloodstream infections ($355 billion) and lower respiratory infections ($261 billion), which together accounted for 74% of economic losses directly attributable to AMR. These are the type of infections that fill intensive care units in every country, rich or poor, Desai said.
The leading drug-resistant pathogens were Klebsiella pneumoniae ($130 billion), Streptococcus pneumoniae ($122 billion), Acinetobacter baumannii ($120 billion), Escherichia coli ($117 billion), Staphylococcus aureus ($115 billion), and Pseudomonas aeruginosa ($75 billion).
‘A warning for everyone’
Desai said knowing which pathogens are the biggest contributors will help policy makers prioritize investments in efforts to reduce AMR. Some of the tools are already available, like pneumococcal conjugate vaccines, which can prevent infections caused by S pneumoniae and in turn reduce the need for antibiotics and lessen the selection pressure for resistant bacteria.Other critical areas of investment include infection prevention and control, rapid diagnostics, antibiotic stewardship, and antibiotic access for low-resource countries.
While low-resource regions bore the highest economic burden in their analysis, Desai said the findings “matter for every country listening.”
“The drug-resistant bacteria don’t carry a passport, and neither do the costs,” he said. “A resistant strain in one region reaches hospitals in the United States and Europe through travel, trade, food, and medical care. So the burden in low-resource regions today is a warning for everyone.”