AMR and Sustainable Development Goals: at a crossroads

Abstract

Antimicrobial resistance (AMR) poses a significant global health threat, primarily stemming from its misuse and overuse in both veterinary and public healthcare systems. The consequences of AMR are severe, leading to more severe infections, increased health protection costs, prolonged hospital stays, unresponsive treatments, and elevated fatality rates. The impact of AMR is direct and far-reaching, particularly affecting the Sustainable Development Goals (SDGs), underscoring the urgency for concerted global actions to achieve these objectives. Disproportionately affecting underprivileged populations, AMR compounds their vulnerabilities, pushing them further into poverty. Moreover, AMR has ramifications for food production, jeopardizing sustainable agriculture and diminishing the livelihoods of farmers. The emergence of antibiotic-resistant bacteria in underprivileged areas heightens the risk of complications and mortality. Climate change further contributes to AMR, as evidenced by increased instances of foodborne salmonellosis and the development of antibiotic resistance, resulting in substantial healthcare costs. Effectively addressing AMR demands collaboration among governments, entrepreneurs, and the public sector to establish institutions and policies across all regulatory levels. Expanding SDG 17, which focuses on partnerships for sustainable development, would facilitate global antimicrobial stewardship initiatives, technology transfer, surveillance systems, and investment in vaccine and drug research. The World Bank's SDG database, tracking progress towards sustainable development, reveals a concerning picture with only a 15% success rate till 2023 and 48% showing deviation, underscoring a global gap exacerbated by the COVID-19 pandemic. Tackling AMR's global impact necessitates international cooperation, robust monitoring, and evaluation methods. The five priorities outlined guide SDG implementation, while impoverished countries must address specific challenges in their implementation efforts. Addressing AMR and its impact on the SDGs is a multifaceted challenge that demands comprehensive and collaborative solutions on a global scale.

Keywords: Alternatives to Antibiotics; Antimicrobial Resistance (AMR); Antimicrobial Stewardship; One Health; Socio-Economic Impacts; Sustainable Development Goals (SDGs).

Fig. 1

Development of antibiotic resistance overtime

Fig. 2

Estimated death count by different diseases till 2050

Fig. 3

Antimicrobial resistance contributing factor

Fig. 4

Priority pathogen list by WHO for developing new antibiotics

Fig. 5

Key elements of antimicrobial stewardship

Fig. 6

Aspects of next generation AMR networking

Fig. 7

Millennium development goals

Fig. 8

SDG index score over time globally (2015–2021)

Fig. 9

One Health

Fig. 10

Goals addressed about AMR are highlighted in red

Fig. 11

Trend of births by skilled health workers over the period of six years (2015-2022)

Fig. 12

SDG’s progress report 2023

Fig. 13

Stratiges to Achieve SDGs in context to AMR