Antimicrobial resistance (AMR) is an urgent public health issue, as resistant genes and pathogens will cross borders and spread without action, threatening medical progress. [1,2,3]  Breakthrough drugs and treatments, particularly those causing immunosuppression or requiring invasive procedures, will be useless if patients receiving them die from untreatable infections. This challenge requires multidisciplinary integrated collaboration and cooperation at the global level.

Many countries in economic transition may view addressing AMR as an unwanted economic burden. However, middle income countries like Brazil, Russia, India, China and South Africa (BRICS) as well as the emerging next economic power countries like Mexico, Indonesia, Nigeria and Turkey (MINT) have high rates of AMR. [4] The fluoroquinolone resistance rates in particular highlight the importance of action in these countries as this drug class is a cornerstone in multidrug-resistant tuberculosis treatment. Seven of these nine countries are classified as tuberculosis high burden. [5] It is important to emphasize that AMR is a threat to economic development in these nine countries, home to more than half of the world’s population. It is estimated that uncontrolled AMR will compress Gross Domestic Product (GDP) by around 5%. [6] If these very large economies fail to reach their economic potential the global economic impact could be substantial. Additionally, there will be underappreciated psychosocial effects leading to reduced productivity as a consequence of AMR-associated increases in mortality. The pressures of economic development and population growth with the increasing demand for food protein mean that antibiotic use in livestock will intensify. Recent data have shown that there will be a 99% increase in antimicrobial use in livestock among BRICS countries. [7] Only three of these BRICS and MINT countries have plans for animal antimicrobial use monitoring systems (China, Russia and Brazil), according to a recent survey by the World Health Organization. [8]

Credit: CDC

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