Patients in North Africa and the Middle East are using antibiotics in sharply rising amounts far above the world average, raising concerns about the increasing risks of drug resistance to treat bacterial infections, according to a new analysis.
The data – mapped by the FT of work led by a team at the University of Oxford and published in Lancet Planetary Health – estimates antibiotic consumption for 204 countries between 2000 and 2018. This shows a 46 percent increase in global antibiotic use, with a boom in nations including Sudan, India and Vietnam.
While many poorer countries have inadequate access to antibiotics, leading to unnecessary deaths due to lack of adequate treatment, other middle- and higher-income countries use volumes far above global norms.
The study, based on a combination of prescription data and statistical modeling, shows that the highest consumption rate in a single country – measured as a defined daily dose per 1,000 people per day – is in Greece, almost 45.9, compared to a global dose averaging 14.3 and an average of 21.1 in Western Europe.
There has also been a sharp rise in the Middle East, where antibiotics are often provided without prescriptions, jeopardizing the development of bacterial strains that are resistant to drugs.
These figures are included in an FT data dashboard designed to track emerging trends in the “silent pandemic” of antimicrobial resistance, causing hundreds of thousands of annual deaths.
The dashboard aims to outline the growth in disease, drug use and responsiveness efforts by companies, governments and others.
The Center for Disease Dynamics, Economics and Policy has also tried to calculate the extent of antibiotic use, and recent studies are underway to link consumption to overall estimates of the burden of antimicrobial resistance.
Compared to the funding and level of research and development activity devoted to other disease categories, such as cancer, the pipeline is thin for new antibiotics, for diagnostics to aid their targeted use, and for vaccines to prevent infection.
An annual measure set by the Access to Medicine Foundation highlights changing efforts by both innovative and generic pharmaceutical companies in a range of activities – including research, supervision and manufacturing – to address antimicrobial resistance.
An analysis by Farm animal Investment risk and return – a brainstorm designed in part to mobilize activist investors to reduce the range of antibiotics in animals – highlights the changing response of the agri-food and restaurant sector.
Governments and other funders have strengthened the support for research on the subject, but with a wide range of different approaches and levels of commitment, as illustrated by the Global AMR R&D Hub.
Broader efforts by countries to improve stewardship, through measures such as improved diagnosis and infection control, are also highly variable, as measured by the Global Coalition on Aging’s Global AMR Readiness Index.