Antimicrobial Resistance and Water: The risks and costs for economies and societies

The document examines how discharges from healthcare, agriculture, and pharmaceutical manufacturing into water systems, combined with poor sanitation and climate change, drive the spread of antimicrobial resistance (AMR). It highlights that while AMR is a global threat, the Global South faces the highest risks due to gaps in water, sanitation, and hygiene (WASH) infrastructure. The report quantifies the severe economic impacts, including billions in healthcare costs and agricultural losses, and uses a hypothetical resistant cholera epidemic in Bangladesh to illustrate the potential for catastrophic health and economic outcomes.

• Waterborne AMR is driven by discharges from four primary sources: healthcare systems (hospital and community waste), agriculture (livestock and crop run-off), aquaculture, and antimicrobial drug manufacturing.
• Antimicrobial consumption is projected to increase by 28% by 2030 for humans and by approximately 50% by 2030 relative to 2013 levels for livestock, with the fastest growth occurring in lower- and middle-income countries (LMICs).
• China and India are dominant in antimicrobial manufacturing, producing between 80% and 90% of the world's antibiotics, which has led to documented localized AMR hotspots in rivers near manufacturing sites.
• Waterborne AMR imposes significant global economic and health burdens, including 15 million disability-adjusted life years (DALYs) yearly and annual economic impacts estimated between $340 and $680 billion.
• The agricultural sector faces potential losses of up to $6 billion per year due to waterborne AMR, with livestock and aquaculture values specifically at risk if animal mortality rates increase.
• Bangladesh is identified as a potential hotspot for a waterborne AMR epidemic; a resistant strain of cholera could plausibly result in 700,000 cases and 140,000 deaths, costing the economy $4 billion.
• Current wastewater treatment technologies are designed for conventional pollutants and cannot entirely eliminate antimicrobials, meaning that without advanced treatment, pollutants continue to spread through waterways.

APA

World Economic Forum (2021). Antimicrobial Resistance and Water: The risks and costs for economies and societies. https://www3.weforum.org/docs/WEF_Antimicrobial_Resistance_and_Water_2021.pdf

Chicago

World Economic Forum. Antimicrobial Resistance and Water: The risks and costs for economies and societies. 2021. https://www3.weforum.org/docs/WEF_Antimicrobial_Resistance_and_Water_2021.pdf.

Wikipedia

{{cite report |author=World Economic Forum |title=Antimicrobial Resistance and Water: The risks and costs for economies and societies |date=August 2021 |url=https://www3.weforum.org/docs/WEF_Antimicrobial_Resistance_and_Water_2021.pdf |access-date=23 October 2026 |via=Climate Insights Directory}}

BibTeX

@techreport{worldeconomicforum2021antimicrobial, author = {{World Economic Forum}}, title = {{Antimicrobial Resistance and Water: The risks and costs for economies and societies}}, institution = {World Economic Forum}, year = {2021}, month = aug, url = {https://www3.weforum.org/docs/WEF_Antimicrobial_Resistance_and_Water_2021.pdf}, urldate = {2026-10-23}, note = {Indexed by Climate Insights Directory} }