Antimicrobial resistance (AMR) jeopardises the effectiveness of many of the most valuable medical and public health advances achieved in the twentieth century. It occurs when the microbes that cause disease evolve so that the medicines which used to kill them no longer work. In 2016, the high-level meeting of United Nation’s General Assembly acknowledged AMR as a fundamental threat to the health of populations, the global economy and society as a whole. It also highlighted the need for countries to urgently put in place policies to tackle AMR and prevent its disastrous consequences.

The Organisation for Economic Co-operation and Development (OECD) has been asked by its Member countries to assess which actions should be taken to prevent the emergence and spread of AMR, and to help governments to implement them. This report responds to that mandate and to a call from the European Commission – as part of its global strategy to tackle AMR – to conduct a health economic evaluation of AMR, determine its current and long-term public health and economics consequences, and assess the effectiveness and cost-effectiveness of public policies to contain it. The findings presented in this publication identify ‘best buys’ – i.e. affordable, feasible and highly cost-effective interventions – among control policy options for AMR in the human health sector.

This publication presents a series of novel analyses to guide countries in their policy-making process. The OECD has used advanced analytical approaches – including microsimulation and ensemble modelling techniques – to provide a precise assessment of the potential impact of public policy options to address AMR. The country-specific results reported, represent the most comprehensive and detailed assessment of AMR health and economic effects that have yet been undertaken in different national contexts. For the first time, empirical evidence is presented showing that AMR can be reduced significantly and its burden on population health and healthcare expenditure drastically reduced.

The work presented in this report was conducted by the OECD in close collaboration with the European Centre for Disease Prevention and Control, who provided expertise and valuable epidemiological data on AMR. It also benefited greatly from inputs and comments from member countries and various stakeholders. The Health Committee and one of its subsidiary bodies, the Expert Group on the Economics of Public Health, oversaw the preparation of the report. It is published under the responsibility of the Secretary General of the OECD, and does not necessarily reflect the views of individual member states.

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