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Antimicrobial Resistance: The Major Contribution of Poor Governance and Corruption to This Growing Problem

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  • Peter Collignon
  • Prema-chandra Athukorala
  • Sanjaya Senanayake
  • Fahad Khan

Abstract

Objectives: To determine how important governmental, social, and economic factors are in driving antibiotic resistance compared to the factors usually considered the main driving factors—antibiotic usage and levels of economic development. Design: A retrospective multivariate analysis of the variation of antibiotic resistance in Europe in terms of human antibiotic usage, private health care expenditure, tertiary education, the level of economic advancement (per capita GDP), and quality of governance (corruption). The model was estimated using a panel data set involving 7 common human bloodstream isolates and covering 28 European countries for the period 1998–2010. Results: Only 28% of the total variation in antibiotic resistance among countries is attributable to variation in antibiotic usage. If time effects are included the explanatory power increases to 33%. However when the control of corruption indicator is included as an additional variable, 63% of the total variation in antibiotic resistance is now explained by the regression. The complete multivariate regression only accomplishes an additional 7% in terms of goodness of fit, indicating that corruption is the main socioeconomic factor that explains antibiotic resistance. The income level of a country appeared to have no effect on resistance rates in the multivariate analysis. The estimated impact of corruption was statistically significant (p

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  • Peter Collignon & Prema-chandra Athukorala & Sanjaya Senanayake & Fahad Khan, 2015. "Antimicrobial Resistance: The Major Contribution of Poor Governance and Corruption to This Growing Problem," PLOS ONE, Public Library of Science, vol. 10(3), pages 1-13, March.
    • Handle: RePEc:plo:pone00:0116746
    DOI: 10.1371/journal.pone.0116746
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    1. Rohan Best & Paul J. Burke, 2017. "The Importance of Government Effectiveness for Transitions toward Greater Electrification in Developing Countries," Energies, MDPI, vol. 10(9), pages 1-17, August.
    2. Irene Anna Lambraki & Melanie Cousins & Tiscar Graells & Anaïs Léger & Patrik Henriksson & Stephan Harbarth & Max Troell & Didier Wernli & Peter Søgaard Jørgensen & Andrew P Desbois & Carolee A Carson, 2022. "Factors influencing antimicrobial resistance in the European food system and potential leverage points for intervention: A participatory, One Health study," PLOS ONE, Public Library of Science, vol. 17(2), pages 1-19, February.
    3. Heinzel, Mirko & Koenig-Archibugi, Mathias, 2024. "National action on antimicrobial resistance and the political economy of health care," LSE Research Online Documents on Economics 122251, London School of Economics and Political Science, LSE Library.
    4. Roberta Magnano San Lio & Giuliana Favara & Andrea Maugeri & Martina Barchitta & Antonella Agodi, 2023. "How Antimicrobial Resistance Is Linked to Climate Change: An Overview of Two Intertwined Global Challenges," IJERPH, MDPI, vol. 20(3), pages 1-18, January.
    5. Felicia Robertson & Sverker C. Jagers & Björn Rönnerstrand, 2018. "Managing Sustainable Use of Antibiotics—The Role of Trust," Sustainability, MDPI, vol. 10(1), pages 1-13, January.

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