NCPA - National Center for Policy Analysis


September 18, 2008

Antimicrobial drugs are designed to fight infectious diseases, but the germs are fighting back -- and winning.  Worse, the public has failed to grasp the global health threat posed by infectious diseases that are resistant to therapeutic drugs.  Our complacency will be costly -- and surely deadly, warns the RAND Institute.

Antimicrobial resistance, or AMR, magnifies the threat from major infectious diseases for which there are therapeutic drugs but no vaccines: Malaria, tuberculosis (TB), HIV, diarrheal diseases and acute respiratory diseases.  Compared with treating infections that respond well to ordinary treatments, treating drug-resistant infections is generally more difficult, more expensive and not as successful, says RAND:

  • A case of malaria once could be treated with a single drug for about eight cents; now, because of resistance, treatments can cost as much as $35.
  • About five percent of nine million new cases of TB are resistant to at least two of the four standard drugs used.
  • Treatment for drug-resistant TB costs about 200 times more than standard treatment and still results in lower cure rates.

Moreover, drug resistance is due in large part to antimicrobial drug misuse, including:

  • Doctors prescribing too low of a dose for too short of a time, or the wrong drug.
  • Patients sometimes improperly self-medicate or demand inappropriate treatment.
  • Drug quality is uneven.
  • Poor hospital infection control and the inappropriate use of antibiotics in food animal production also contribute.
  • Compounding the problem, market forces have led to lagging innovation in antimicrobial drugs.

Source: Melinda Moore, "Beating the Germ Insurgency," RAND Review, Summer 2008.

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