Antimicrobial and Antibiotic Resistance in Developing Countries: Health Economics, Global Governance, and Sustainable Development Goals

The biological evolution of communicable pathogens has been accelerated due to the misuse of antibiotics in human and animal health, as well as due to the pharmaceutical contamination of water and soil. The spread of antimicrobial resistance has been facilitated also with the adoption of a political-economical model leaving the development of new pharmaceutical products conditional to the financial assessment of private stakeholders. As demonstrated by the SARS-CoV-2 outbreak, the emergence of mutant pathogens has severe implications in the socio-economic and public governance domains. From this perspective, antibiotics resistance (ABR) – and antimicrobial resistance (AMR) tout court – represent a tangible threat for national and international policymakers aiming to enhance people’s well-being. The goal of this chapter is to assess in low-income countries the cumulative impact of AMR over the capabilities of national authorities to implement and achieve the Sustainable Development Goals (SDGs). Introduced in 2015 with the launch of the UN 2030 Agenda, the SDGs are designed to provide common integrated targets influencing the formulation of development policies at national, regional, and international levels. The chapter presents a detailed overview of the socio-economic costs resulting from the emergence of drug-resistant diseases, intersected with a critical assessment of the SDGs dedicated to healthcare services and societal well-being. Crossing the key findings from the socio-economic impact of AMR and the UN developmental targets in the field of health, the final section illustrates the horizontal detrimental impact of AMR and ABR on the developmental capabilities of national authorities from low-income countries. The conclusion of the chapter advances pragmatic suggestions for the challenges detected.