Where Resistance Spreads: Across the World
Antimicrobial resistance has been identified in all regions of the world and can rapidly spread. The amount of resistance and number of infections is different worldwide, along with the use of antibiotics and antifungals, access to clean water and adequate sanitation, vaccination coverage, and access to quality healthcare.
There are considerable knowledge gaps regarding how much antimicrobial resistance occurs globally. This is especially seen in low- and middle-income countries lacking laboratories to test for resistance and systems to collect infection data.
Antimicrobial resistance is an urgent global public health threat, killing at least 1.27 million people worldwide and associated with nearly 5 million deaths in 2019. In the U.S., more than 2.8 million antimicrobial-resistant infections occur each year. Germs will inevitably find ways to resist antibiotics and antifungals, which is why aggressive action is needed now to keep new resistance from developing and to prevent the resistance that already exists from spreading.
How Germs Can Spread
Germs can spread within healthcare facilities, communities, our food supply, and the environment. Modern travel of people, animals, and goods means resistance can easily spread. One billion people cross through international borders each year. This includes 350 million travelers arriving in the U.S. through more than 300 points of entry.
The capacity and resources for infection prevention and control vary worldwide. A resistant threat somewhere can quickly become a threat anywhere. When infection prevention and control capacity is strengthened in a country, the world benefits. Global efforts can contribute to solutions that protect people from this threat, including:
- Improve quality and consistency of infection control nationwide
- Detect and respond to resistance early, containing it before it becomes common
- Enhance and develop products that improve hygiene, prevent infections, and keep germs from spreading
- Increase education and awareness around infection prevention and control
About Global Antibiotic/Antifungal Use
Download a printable hand out highlighting information on this webpage: Antibiotic Resistance Spreads Easily Across the Globe [PDF – 1 page].
COVID-19 Impacts Antimicrobial Resistance
Much of the U.S. progress in combating antimicrobial resistance was lost in 2020, in large part, due to the effects of the COVID-19 pandemic. The pandemic pushed healthcare facilities, health departments, and communities near their breaking points.
Find out more about the impact of COVID-19 on antimicrobial resistance in the U.S.
An important driver of resistance is antibiotic and antifungal use. Antibiotics and antifungals are valuable tools. People should always be promptly treated when the drugs are needed for infections and to prevent sepsis. However, any use—for people, animals, or plants—can cause side effects and lead to antimicrobial resistance.
In the U.S., 5 out of 6 people are prescribed an antibiotic each year—at least 30% of this antibiotic use is unnecessary. According to the Center for Disease Dynamics, Economics & Policy’s (CDDEP) 2021 global analysis of antibiotic resistance [PDF – 136 pages], global antibiotic consumption in humans increased by 65% between 2000 and 2015, whereas consumption in animals is expected to increase by 11.5% between 2017 and 2030. If nothing changes, antibiotic consumption is likely to increase worldwide by 200% between 2015 and 2030.
Globally, the use of antibiotics and antifungals are increasing, particularly in low- and middle-income countries as antibiotics and antifungals become more accessible and affordable. Yet some parts of the world cannot access antibiotics and antifungals when they need them, putting patients at risk. While some vaccines are available, low vaccination coverage, coupled with poor water, sanitation, and hygiene infrastructure, leaves many people vulnerable to infection and dependent on antibiotics for treatment.
Everyone should have access to antibiotics and antifungals that work when they are needed. Every country should work to reduce unnecessary use of these drugs; improve access; implement and measure stewardship programs; and track use and use the data to advance solutions.
Video: CDC and Partners Fight a Global Threat
CDC works with partners worldwide to protect people from antimicrobial resistance, one of today’s greatest challenges because resistance can easily travel across borders as people and goods move. Watch the video for examples of CDC’s partnerships helping to improve antibiotic and antifungal use and stop the spread of germs.