Center for Disease Dynamics, Economics & Policy

Resistance to anti-infective drugs, particularly bacterial resistance to antibiotics, is a global phenomenon. Resistant infections increase morbidity and mortality and prolong the time of infectiousness, putting others at risk. In high income countries, where the burden of infectious diseases is modest, the decreasing effectiveness of first line antibiotics is overcome by more expensive second and third line antibiotics. The challenge is greater in developing countries, where the burden of infectious diseases is high and patients with a resistant infection may be unable to obtain or afford any antibiotic, let alone expensive second line treatments. Poor hygiene, unreliable water supplies, civil conflicts, and increasing numbers of immunocompromised people with HIV infection, facilitate both the evolution of resistant pathogens and their rapid spread.