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국회도서관 홈으로 정보검색 소장정보 검색

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Title page

Contents

Foreword 8

Acknowledgements 10

List of abbreviations 11

Executive summary 12

METHODOLOGY 12

RESULTS 13

Effect of AMR on mortality 13

Effect of AMR on the economy 13

Results of intervention scenarios 13

COST OF INTERVENTIONS AND RETURN ON INVESTMENT 15

CHAPTER 1. Introduction 16

CHAPTER 2. Methodology 17

ESTIMATES OF THE BURDEN OF DISEASE ASSOCIATED WITH AMR 17

ESTIMATES OF THE ECONOMIC COST OF AMR 18

ESTIMATES OF THE COST OF INTERVENING TO PREVENT AMR 20

CHAPTER 3. Results 21

COST PER HOSPITAL ADMISSION 21

Number of hospital admissions for antibiotic-resistant infections 22

Current cost of AMR for in-patient health care and treatment of tuberculosis 24

LITERATURE REVIEW ON RESILIENCE SECTORS TO PRIORITIES 25

DIRECT EFFECT OF AMR ON OUTPUT 26

QUALITATIVE FINDINGS ON INDIRECT LABOUR, TOURISM AND HOSPITALITY 27

Experts' views on the effect of AMR on labour force participation 28

Experts' views on the effect of AMR on tourism 29

Experts' views on the effect of AMR on hospitality 30

Factors affecting a country's resilience to an AMR shock 31

IMPACT OF AMR UNDER DIFFERENT SCENARIOS 34

Overview of intervention scenarios 34

Better treatment of bacterial infections 37

Improved innovation and the rollout of effective new gram-negative antibiotics 39

Better treatment and increased innovation 40

Combined interventions scenario 41

Accelerated rise in resistance scenario 41

RETURN ON INVESTMENT 44

Return on investment in improved treatment of bacterial infections 44

Return on investment in increased access to new drugs 44

Return on investment in vaccination and intervention 45

Return on investment in WASH interventions 45

Cost-effectiveness of improving health treatment and innovation of new antimicrobials 45

CHAPTER 4. Discussion 47

COMPARISON WITH OTHER STUDIES 47

Health care costs 47

Macroeconomic burden 47

GDP-based health valuation 48

STRENGTHS AND LIMITATIONS OF THIS STUDY 48

Scope 48

Health cost model 49

Resilience model 49

Macroeconomic model 49

Implementation cost model 50

POLICY IMPLICATIONS 50

References 51

Annex A. Experts who completed the study survey and interview 55

TABLE E.1. Deaths averted, health care cost savings, macroeconomic benefits and a GDP-based health valuation in 2050 under five AMR scenarios (in billion... 14

TABLE 3.1. Projected morbidity caused by AMR in 2030 in all countries, in the business-as-usual scenario 27

TABLE 3.2. Correlation between resilience responses generated from different experts, using 2030 data 32

TABLE 3.3. Correlation between changes in AMR death rate and resilience, by sector 33

TABLE 3.4. Deaths averted, health care cost savings, macroeconomic benefits and a GDP-based health valuation in 2050 under five AMR scenarios (in billion... 36

TABLE 3.5. Economic impacts in 2030, 2040 and 2050 of better treatment of bacterial infections 38

TABLE 3.6. Sectors driving the macroeconomic shock in 2050 from better treatment of bacterial infections in all countries 38

TABLE 3.7. Economic impacts in 2030, 2040 and 2050 of improving innovation and rolling out gram-negative antibiotics 39

TABLE 3.8. Sectors driving the macroeconomic shock associated with increased innovation and the rollout of effective new gram-negative antibiotics in all countries... 40

TABLE 3.9. Economic impacts in 2030, 2040 and 2050 of improving treatment and innovation 40

TABLE 3.10. Sectors driving the macroeconomic change associated with improving treatment and innovation 41

TABLE 3.11. Economic impacts in 2030, 2040 and 2050 of the combined scenario 42

TABLE 3.12. Sectors driving the macroeconomic changes associated with improving treatment and innovation 42

TABLE 3.13. Economic impacts in 2030, 2040 and 2050 of the accelerated rise in resistance scenario 43

TABLE 3.14. Sectors driving the macroeconomic changes associated with the accelerated rise in resistance scenario 43

TABLE 3.15. Average cost of in-patient and out-patient antibiotics and health care, by World Bank income group (US$ at 2022 value, in millions) 44

TABLE 3.16. Estimated annual costs and benefits of improving treatment and innovation in 2050, by World Bank income group (US$ at 2022 value, in billions,... 46

TABLE 4.1. Comparison of returns on investment of interventions in Bonniefield and Towse (2022) and this report 48

FIGURE E.1. Per cent and total GDP impact in 2050 due to improved treatment and innovation (in billion US$) 14

FIGURE E.2. Estimated annual costs (in US$) and benefits in 2050 of better treatment for bacterial infections and innovative new gram-negative drugs 15

FIGURE 2.1. Workstreams used to estimate the health burden of AMR 17

FIGURE 3.1. Cost per antibiotic-resistant admission, by syndrome and World Bank income group 21

FIGURE 3.2. Excess cost per antibiotic-resistant hospital admission, by syndrome and World Bank income group 22

FIGURE 3.3. Cost per hospital admission of antibiotic-resistant and antibiotic-susceptible infections, and ratio of those resistant to susceptible infections,... 23

FIGURE 3.4. Percentage of hospital admissions that involve an antibiotic-resistant infection, by World Bank income group 23

FIGURE 3.5. Estimated direct excess cost associated with hospital admissions for antibiotic-resistant infections, by World Bank income group (US$ billions) 24

FIGURE 3.6. Percentage of in-patient health care costs associated with antibiotic-resistant infections in 2022, by World Bank income group 25

FIGURE 3.7. Experts' estimates of impact of eight-fold increase in AMR on indirect labour, tourism and hospitality 28

FIGURE 3.8. Experts' estimates of the effect of AMR on labour force participation 29

FIGURE 3.9. Experts' estimates of the effect of AMR on tourism if all countries are affected equally 30

FIGURE 3.10. Experts' estimates of effect of AMR on tourism in a country in which resistance rates rise while resistance remains stable in other countries 30

FIGURE 3.11. Experts' estimates of the effect of AMR on hospitality 31

FIGURE 3.12. Twelve variables that experts view as most important for determining how resilient a country is to an AMR shock 31

FIGURE 3.13. Average resilience scores for labour, tourism and hospitality, by country, 2030 33

FIGURE 3.14. Correlation between average sector resilience and AMR death rate, by World Bank income group, 2030 34

FIGURE 3.15. Global increase in excess in-patient health care costs associated with AMR, by World Bank income group, 2020-2050 35

FIGURE 3.16. Population and labour force changes by 2050 relative to the business-as-usual scenario in a world without AMR, by World Bank income group 35

FIGURE 3.17. Health care cost savings of five AMR intervention scenarios in 2050 36

FIGURE 3.18. Macroeconomic impact (change in GDP) of five AMR intervention scenarios in 2050 37

FIGURE 3.19. Per cent and total GDP impact in 2050 due to improved treatment and innovation (in billion US$) 37

FIGURE 3.20. Estimated annual costs (in US$) and benefits in 2050 of better treatment for bacterial infections and innovative new gram-negative drugs 46

Annex Tables

TABLE A.1. Experts who completed the study survey and interview 55