Drug-Resistant Infections Linked to $3.5 Trillion in Global Economic Losses in 2021

Antimicrobial resistance, which occurs when bacteria evolve to survive the drugs designed to kill them, was linked to $3.5 trillion in lost economic welfare worldwide in 2021, equal to 2.25% of global gross domestic product, according to a new study presented at IDWeek 2026. Of that total, $835 billion, or 0.54% of global GDP, was directly caused by resistance — losses that would not have occurred had the same infections responded to standard antibiotics. 

The study combined estimates of healthy years of life lost, measured as disability-adjusted life-years, from the Global Burden of Disease 2021 MICROBE tool with World Bank GDP and population data and applied a standardized Value of Lost Welfare framework across 21 world regions, 12 infectious syndromes and 22 bacterial pathogens, pinpointing not only how much AMR costs, but where the losses occur and which infections and bacteria drive the burden.  

Bloodstream infections ($355 billion) and lower respiratory infections such as pneumonia ($261 billion) accounted for nearly three-quarters of AMR-attributable economic losses. Klebsiella pneumoniae ($130 billion), Streptococcus pneumoniae ($122 billion), Acinetobacter baumannii ($120 billion), Escherichia coli ($117 billion), Staphylococcus aureus ($115 billion) and Pseudomonas aeruginosa ($75 billion) were the leading pathogens, accounting for 82% of direct AMR-related losses. Gram-negative bacteria contributed more than 60% of losses. 

Researchers found that lower-resource regions carried the heaviest burden relative to GDP. The largest dollar losses were in South Asia ($101 billion), East Asia ($82 billion) and high-income North America, including the United States and Canada ($70 billion). Relative to the size of its economy, Western sub-Saharan Africa was hit hardest, losing 1.42% of GDP, 2.6 times the global average and more than five times the share in North America. 

“These are not just numbers. Every dollar represents years of healthy life lost to infections we once knew how to cure,” said Hardik Dineshbhai Desai, MBBS, public health researcher at AB Plus Multispecialty Hospital in Ahmedabad, India, and Digantkumar Patel, MD, hospitalist at Springfield Clinic in Springfield, Illinois, co-investigators of the study. 

“Drug-resistant bacteria don’t carry passports, and neither do their costs,” Dr. Desai and Dr. Patel said. “A resistant strain that takes hold in one part of the world can reach hospitals in the United States, Europe or elsewhere through travel, trade, food systems and medical care across borders. The burden that lower-resource regions carry now is an early warning for every country. Investing in stewardship, diagnostics, vaccination, infection prevention and antibiotic access where the toll is heaviest is not charity; it is one of the smartest ways for the United States and every developed nation to protect its own patients and its own economy.” 

In addition to Dr. Desai and Dr. Patel, study co-investigators include: Jagadish Koyi, MD; Mounika Kotte, MBBS; Siri Vummaneni, MBBS; and Parth Sudhendu Patel, MBBS, MD. 

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