Assessing the global poverty effects of antimicrobial resistance

• Published in: World development 2018-11, Vol.111, p.148-160
• Main Authors: Ahmed, Syud Amer, Barış, Enis, Go, Delfin S., Lofgren, Hans, Osorio-Rodarte, Israel, Thierfelder, Karen
• Format: Article
• Language: English
• Subjects: Antiinfectives and antibacterials; Antimicrobial agents; Antimicrobial resistance; Clinical outcomes; Cost assessments; Drug resistance; Dynamic computable general equilibrium modeling; Economic conditions; Economic growth of open economies; Economics; Employment; Exports; GDP; Global economy; Gross Domestic Product; Health (pandemics); Health care expenditures; Health care policy; Impact analysis; Income; International cooperation; Labor productivity; Livestock; Low income groups; Macroeconomics; Measurement and analysis of poverty; Mortality; Pandemics; Poverty; Present value; Productivity; Resilience; Resistance; Trade flows; Wage & price controls
• ISSN: 0305-750X; 1873-5991
• DOI: 10.1016/j.worlddev.2018.06.022

•By 2050 there may be 28.3 million more people living below PPP $1.90/day, 26.2 million of those in low-income countries.•Expected losses from AMR in 2015–50 may sum to $85 trillion in GDP and $23 trillion in global trade (in present value).•By 2050, global GDP could deviate negatively by 3.8 percent from the baseline (worst case scenario) due to AMR.•AMR makes it more difficult to eliminate extreme poverty.•Isolationist policies in response to AMR further increase global poverty. As a result of antimicrobial resistance (AMR), economies will experience an increase in mortality, reduced productivity for labor and the livestock sector, and increased health care costs. This paper assesses the potential global poverty impacts of AMR using a unique macro-micro framework. To estimate poverty effects of AMR, price, wage, and employment results from a dynamic, multi-country, multi-sector computable general equilibrium CGE model are used in a microsimulation model that integrates household surveys from 104 countries. The analysis in this paper advances other studies of AMR in two ways: (1) it links macro results to a microsimulation model to provide insight on poverty impacts for the world economy and countries of different income levels; and (2) it uses a global multi-sector model, rather than an aggregate global model, to generate macroeconomic results with structural details for capturing the economy-wide impact within countries and the spread across countries via trade flows. Relative to a world without AMR, the progression of antimicrobial resistance is expected to make it more difficult to eliminate extreme poverty, potentially adding 24.1 million people to become extremely poor, of whom 18.7 million live in low-income countries. The expected losses during 2015–50 may sum to $85 trillion in gross domestic product and $23 trillion in global exports (in present value). By 2050, the global gross domestic product could deviate negatively by 3.8 percent from the baseline (in the worst-case scenario considered). Because it is a global public bad, the optimal policy response will require global cooperation. The poverty outcomes induced by AMR in all country groups will deteriorate with short-sighted isolationist policies. Moreover, assistance from high-income countries to improve the economic resiliency of lower-income countries will also benefit the higher-income countries and world economy in general.