Antibiotic resistance and Sustainable Development Goals
The Sustainable Development Goals (SDG’s) guide investment in sustainable development, and the lack of inclusion of antibiotic resistance has therefore been problematic. The recent review has added one indicator of resistant infections, but most of the links between resistance and the SDG’s are still implicit. Even so, rising awareness of the importance and fragility of global health can hopefully pave way for a greater recognition of the intimate connections between antibiotic resistance and sustainable development.
The Sustainable Development Goals are widely used to guide the policies of countries, funding agencies and corporate CSR efforts. Progress is tracked by over 24 000 different indicators, and a report from McKinsey from 2018 concluded that around 40% of indicators in the SDGs are relevant for antimicrobial resistance. Yet, until the recent change there was not any explicit mention of resistance in the SDG’s beyond the preamble and not a single indicator that tracked it.
The new indicator that was introduced in March is on reducing the percentage of bloodstream infections due to selected antimicrobial-resistant organisms, set under the Global health goal. Many other targets in the Global health goal will be impossible to achieve without effective antimicrobials. Maternal mortality, new-born and under-five children mortality, communicable and non-communicable diseases are all closely linked to the ability to effectively treat bacterial infections.
As have become exceedingly obvious to everyone over the last few months, global health is also intimately linked to other kinds of progress. A threat to functioning healthcare is also a threat to achievement of other Sustainable Development Goals. Poverty increases when workers without a safety-net fall sick or die and leave their dependants unsupported, or when a great share of income has to be spent on healthcare. Gender equality is also prone to setbacks with increasing antibiotic resistance; women do most of the unpaid work of caring for sick relatives, at the expense of career and education.
It is still thankfully rather uncommon with entirely untreatable bacterial infections, where no antibiotic at all could work. However, the so-called “last-line antibiotics” that are used for serious resistant infections when no other option exists often cause severe side-effects, prolonged treatments and lower success rates. This severely decreases the well-being and productivity of the patient who will be at high risk of losing their job or even their ability to work. Even in places where there is a social safety net, such developments on a broader scale can make the goal of economic growth a challenge. Other goals that appear unrelated to health, such as Clean Energy and Climate Action, depend on economic growth for investments, as well as on a healthy and innovative workforce.
In an evermore complex and interlinked society, it is certainly difficult to produce a comprehensive framework of indicators to capture the progress of sustainable development. The review of the SDG’s considered not only relevance, but also availability of global data (which is a challenge in the antibiotic resistance field), and the reporting burden on national statistical systems. Even if there is only the one official antibiotic resistance indicator among the Sustainable Development Goals, rising awareness of the importance and fragility of global health can hopefully pave way for a greater recognition of the intimate connections between antibiotic resistance and sustainable development.
As have become exceedingly obvious to everyone over the last few months, global health is also intimately linked to other kinds of progress. A threat to functioning healthcare is also a threat to achievement of other Sustainable Development Goals.