Introduction

The report examines how antimicrobial resistance (AMR), focused on bacterial infections, affects mortality, health systems and the global economy. AMR currently causes around 1.27 million deaths annually and could exceed 1.8 million by 2050, with impacts concentrated in low- and lower-middle-income countries.

Methodology

Health burden projections from IHME under a business-as-usual case and five intervention or accelerated resistance scenarios feed into health-cost, economic resilience and macroeconomic workstreams. Literature, epidemiological data and expert elicitation (21 experts) are used to estimate health-care costs, labour effects, tourism, hospitality, and the cost of interventions, including antibiotics, vaccines and WASH.

Results

Median cost per resistant admission ranges from about US$100–1,000 in low-income to US$3,000–30,000 in high-income countries, with resistant cases costing 1.4–22.6 times more than susceptible ones depending on income group and syndrome. AMR-related in-patient excess costs are estimated at US$66 billion annually (about 0.7 per cent of global health spending), rising to US$159 billion by 2050 if resistance follows historical trends, with bloodstream and lower-respiratory infections driving most costs.

Effect of amr on mortality

Under business-as-usual, AMR is projected to cause 38.5 million deaths between 2025 and 2050. Compared with this, Scenario 1 (better bacterial treatment) averts about 90 million deaths, Scenario 2 (new gram-negative antibiotics) 10 million, Scenario 3 (combined treatment and innovation) 100 million, Scenario 4 (combined interventions including vaccines and WASH) 110 million, while an accelerated resistance scenario results in 6.7 million additional deaths.

Effect of amr on the economy

If resistance trends continue, direct AMR health costs reach US$159 billion (around 1.2 per cent of health expenditure) by 2050, with 3.5 per cent of global admissions involving resistant infections. Without AMR deaths, the 2050 population would be 22.2 million higher and the labour force 8 million larger; experts expect higher AMR to dampen tourism and hospitality, especially in poorer countries, with relative resistance levels between countries shaping tourism flows.

Results of intervention scenarios

Scenario 1 (better treatment) saves about US$19 billion in annual health costs and increases GDP by US$269 billion by 2050. Scenario 2 (innovation and rollout of effective new gram-negative antibiotics) saves about US$84 billion in health costs, delivers US$740–743 billion in extra GDP and health gains valued at roughly US$174 billion.

Better treatment and innovation together (Scenario 3) reduce health costs by about US$97 billion and raise GDP by about US$959–960 billion by 2050, with health benefits valued around US$679 billion. A broader combined package (Scenario 4) including vaccines and WASH yields the largest health cost savings (about US$99 billion) and GDP gains close to US$990 billion, while an accelerated resistance scenario increases annual health costs by about US$176 billion and reduces GDP by about US$1.7 trillion by 2050.

Cost of interventions and return on investment

Meeting global needs for new antibiotics is modelled as developing ten new drugs per decade, two-thirds for gram-negative bacteria, at about US$3.3 billion per drug, implying annual R&D of roughly US$2.2 billion rising to US$3.7 billion (2022 prices) by 2050. Improving treatment quality and access to match outcomes in the 85th percentile of countries costs about US$59 billion per year, so combined R&D and treatment improvements total around US$63 billion annually and generate a global return on investment of about 28:1 once macroeconomic and health benefits are included.

Discussion

Compared with earlier global AMR assessments, this study uses more granular national-level burden and cost data and finds a smaller GDP hit under high-resistance scenarios (around 0.9 per cent by 2050) because most AMR deaths occur in older, non-working-age populations. The analysis suggests that expanding antibiotic innovation, strengthening bacterial treatment, vaccines and WASH would, over time, save health systems more than they cost and generate sizable GDP and health gains, but notes uncertainty around admissions, cost estimates, behavioural responses and implementation capacity.