Superbugs on the rise: Asia at the epicentre of the global fight against antimicrobial resistance
- Ahmed Toure
- May 30
- 4 min read
As the world celebrates advancements in medicine and life expectancy, a silent and lethal threat continues to grow, one that could reverse decades of progress in global health. A new report published by the World Economic Forum (WEF), in collaboration with the Centre for Impact Investing and Practices (CIIP) and the Philanthropy Asia Alliance (PAA), delivers a sobering prognosis: by 2050, antimicrobial resistance (AMR) could claim 10 million lives annually, outpacing cancer as the leading cause of death.
The report, "Targeted Action and Financing the Fight Against Antimicrobial Resistance in Asia," positions the Asia-Pacific region as both ground zero for the crisis and a critical battleground for its resolution. The document underscores the urgent need for targeted financing, integrated policies, and a robust commitment to innovation to tackle a threat described as “a systemic risk akin to COVID-19 and the 2008 financial crisis.”
The science behind the crisis
AMR occurs when microorganisms, bacteria, viruses, fungi and parasites, evolve to resist antimicrobial drugs designed to kill them. This process, although naturally occurring, has been significantly accelerated by the misuse and overuse of antimicrobials in humans, animals, and agriculture.
According to the report, bacterial AMR alone was directly responsible for 1.14 million deaths in 2021 and contributed to 4.71 million deaths globally. Asia accounted for more than half of this burden. Without intervention, this figure could rise to over 8 million deaths annually by 2050.
A major concern lies in the widespread use of antibiotics without proper diagnostics. Globally, nearly 50% of antibiotic regimens are initiated without a confirmed diagnosis and often employ the wrong drug, fuelling resistance rather than curing infections. This not only leads to treatment failure but also selects for and propagates drug-resistant strains.
In agriculture, the use of antibiotics in livestock far surpasses human consumption. The report details that approximately 90% of antibiotics administered to animals are excreted into the environment, contaminating soil and waterways. These residues create reservoirs of resistance genes, facilitating horizontal gene transfer among microbial communities. This increases the likelihood of multidrug-resistant pathogens entering the food chain and human populations.
The environmental implications are profound. In Malaysia, for instance, a recent study found that 40% of Escherichia coli and Salmonella isolates in treated drinking water were resistant to multiple drugs. Such findings indicate that freshwater systems in Southeast Asia are becoming primary reservoirs for AMR organisms, endangering both urban and rural populations.
Climate change exacerbates this risk. Rising temperatures, extreme weather events, and flooding compromise sanitation infrastructure and increase the spread of waterborne diseases. Research cited in the report found that nearly 60% of known infectious diseases are aggravated by climate factors, which, in turn, drive irrational antibiotic use due to misdiagnosis of viral infections (e.g., dengue) as bacterial, leading to unnecessary antibiotic prescriptions.
Economic and developmental impact
The economic implications are equally dire. Unchecked AMR is expected to slash between 1.1% and 3.8% from annual global GDP by 2050, disproportionately affecting low- and middle-income countries (LMICs). In Asia alone, AMR-related costs could reach between $550 and $700 billion by mid-century.
Hospitals across the region are already feeling the strain. The cost of treating a single patient with drug-resistant sepsis in India can exceed $1,000 per day, more than double the cost of supportive care. This financial burden, combined with weakened health systems and high rates of out-of-pocket expenditure, is making quality care increasingly inaccessible for the most vulnerable.
The agriculture sector is also at risk. The World Bank estimates that livestock productivity may fall by up to 7.5% annually due to resistant infections, with related losses in poultry and dairy production compounding food insecurity and economic instability.
A region in the crosshairs
Asia's vulnerability to AMR stems from several converging factors: limited healthcare infrastructure, rising antibiotic consumption, inadequate water and sanitation facilities, counterfeit pharmaceuticals, and unsustainable agricultural practices.
The report highlights that the risk of hospital-acquired infections in Asia-Pacific is up to 20 times higher than in high-income countries, a result of overcrowded hospitals, insufficient infection control measures, and lack of clinical microbiologists. Meanwhile, over-the-counter antibiotic sales and widespread self-medication continue unabated in many Asian countries, weakening formal surveillance and treatment efforts.
A particularly alarming trend is the surge in AMR-related deaths among the elderly. Between 1990 and 2021, deaths among people aged 70 and older increased by more than 80%. Given that one in four Asians will be over 60 by 2050, the demographic implications are enormous.
A strategic framework for action
To stem the tide, the WEF proposes a "three sprints and one marathon" approach:
· Educate: Enhance awareness and responsible use of antimicrobials among clinicians, patients, and farmers.
· Prevent: Invest in diagnostics, WASH (water, sanitation, and hygiene) infrastructure, and infection prevention systems.
· Monitor: Strengthen regional surveillance, data sharing, and genomic analysis to track and predict emerging resistance patterns.
· Treat (Marathon): Support research and development of novel antibiotics, diagnostics, and vaccines, while ensuring equitable access.
The Davos Compact on AMR, launched at the WEF’s 2025 Annual Meeting, calls on the private sector, impact investors, and philanthropic organisations to co-invest in these strategies. The Unified Coalition for AMR Response (UCARE) aims to mobilise public-private capital and unlock sustainable financing mechanisms for AMR solutions.
A call to the Global Community
Asia has shown a political commitment to combat AMR, with several countries adopting national action plans aligned with the Global Action Plan on AMR endorsed by the World Health Assembly in 2015. However, as of 2023, only 25% of countries are effectively implementing these plans, according to The Lancet.
What is needed now is stronger enforcement, better integration across sectors, and bold investments. A One Health approach, recognising the interconnectedness of human, animal, and environmental health, must underpin all regional efforts.
As Kenneth Mak, Singapore’s Director-General of Health, aptly put it: “AMR is what many might call a ‘slow burn pandemic’. So far, it has not caused lockdowns like COVID-19. However, its impact on our healthcare systems and communities can be profound.”
Indeed, the clock is ticking. If left unchecked, AMR threatens not only global health but the very fabric of modern civilisation. Asia stands at a crossroads: it can either become the epicentre of catastrophe or the vanguard of a global solution.
