The economic impacts of antimicrobial resistance in livestock (EcoAMR)

What is the issue?

Antimicrobial resistance (AMR) remains a global public health threat with an estimated 4.95 million deaths associated with bacterial AMR in 2019 alone, and the health impact of inaction estimated at 10 million deaths per year by 2050. AMR is a recognised challenge that threatens global health, food and economic security (Gurung et al. 2023; Sharma et al. 2018; Saeed et al. 2022).

The issues around the use of antibiotics in livestock production are complex. Antibiotics play a role in the safe production of affordable food while maintaining good animal health standards. However, many of the pathogens present in animals are also present in humans, and overuse of antibiotics in animals can play a role in developing resistant pathogens that impact on animal and human health. Moreover, practices of using antimicrobials for animal growth further compound challenges.

There has been an increasing interest in the burden of AMR on livestock. The evidence on AMR trends in livestock makes a strong case for AMR to be controlled in dairy, livestock, poultry production and aquaculture as food-producing animals are a main reservoir for zoonotic diseases (Krömker & Leimbach 2017; Kalam et al. 2022; Gilbert et al. 2021; Gurung et al. 2023).

AMR can reduce the efficacy of currently available antimicrobials, resulting in increased treatment failures, severity of infections and reliance on alternatives which may be more expensive or have higher risks of side effects (Magnusson et al. 2021). Inappropriate antimicrobial use creates an environment where resistant bacterial strains can survive, and resistance genes be transmitted (Kalam et al. 2022; Gilbert et al. 2021). Food producing animals exposed to antimicrobials can develop resistance to those therapeutics (Scott at al. 2018; Allel et al. 2023).

How did we help?

The focus of this work was on understanding the economics of AMR and antimicrobial use in livestock. To address these key objectives, we used a number of different research methods including literature reviews, expert interviews and mathematical modelling.

The modelling work aimed to generate new evidence on the economic pathways and burden of AMR in the food animal production, whilst the literature scoping exercise provides broad insights on:

• The mechanisms of AMR in livestock
• The transmission between livestock and humans
• The current practices around antimicrobial use
• The perceived threat and benefit of antimicrobial use and AMR in the livestock community
• The value and feasibility of interventions to mitigate the effects of AMR and prevent antimicrobial use.

Economic impact was considered through the lens of consumer welfare, GDP, changes in tax income, household income and trade (see figure below).

What did we find?

The negative impacts of AMR on livestock production and the global economy will worsen over time if nothing further is done to curb its effects. Moderate harmful spillover effects of antimicrobial use (AMU) and AMR in livestock on human health could lead to cumulative global GDP losses between 2025 and 2050 of US$ 1.1. trillion due to lower labour productivity. In a more pessimistic scenario, the direct AMR burden on livestock and potential spillover effects on humans could cause a cumulative GDP loss of US$ 5.2 trillion by 2050.

There could be significant economic gain from reducing AMU in livestock. The results from economic projections suggested that a global reduction in AMU of around 30% is predicted to lead to a cumulative increase in the global GDP by US$ 120 billion between 2025 and 2050. Interventions targeting AMU and AMR can mitigate resistance rates and offer economic benefits.

There could, however, be challenges with implementing policies aimed at reducing AMU and AMR. A knowledge, attitudes and practices (KAP) case study of over 1,450 livestock and aquaculture farms in Bangladesh found that there is a persistent lack of AMU and AMR awareness. High expenditures on antimicrobials are driven by AMU in animal feed, the use of untrained service providers, disease outbreaks, resistant disease management and farm size.

Interviews were also conducted with key informants in Bangladesh and highlighted that it is difficult to implement policies which tackle AMR due to the lack of financial investment and human resources.

What can be done?

The report presents a series of recommendations to combat the potential economic impact of AMR in livestock:

• Prioritise preventative interventions to reduce the burden of disease in animals.
• Enforce formal prescription practices and improve access and affordability to essential antimicrobials.
• Phase out AMU for growth promotion in food-producing animals.
• Strengthen and institutionalise surveillance systems for AMU and AMR.
• Establish and quantify the spillover linkages and impacts of AMR between food-producing animals and humans.
• Improve awareness by educating farming communities on AMR and training health professionals on the prudent and responsible use of antimicrobials in food-producing animals.
• Promote mechanisms to reward farmers who comply with policies and regulations, and who undertake available training as necessary.
• Sustainably invest and finance initiatives such as:
  • Infrastructure development to generate high-quality data needed for analyses to provide evidence;
  • R&D to mitigate the gap crisis in the animal health sector to reduce AMU and AMR;
  • Analyses to establish the economic impact and to build a case for greater investment in AMR using a One Health approach.

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