Graft, poor governance behind antibiotic resistance globally

In a first of its kind research, Australian researchers have linked antibiotic resistance with poor governance and corruption around the world.

"We found that poor governance and higher levels of corruption are associated with higher levels of antibiotic resistance. It is a finding that will be surprising to most people in the field of medicine," said lead researcher professor Peter Collignon from the Australian National University's (ANU) School of Medicine.

The increase in antibiotic-resistant infections is one of the greatest threats facing modern medicine.

The research, published in the journal PLOS ONE, also found that a country's level of antibiotic resistance is not related to its wealth.

"Countries with higher levels of corruption often had less rigorous and less transparent processes, with less effective controls over areas pertinent to antibiotic resistance," said study co-author and associate professor Sanjaya Senanayake.

These include factors that affect antibiotic usage and the ways antibiotic-resistant bacteria spread via water, foods and poor infection control.

In countries with greater corruption, antibiotic usage may also be much higher than what is recorded.

"If governance and control of corruption can be improved, this can be an important factor in reversing high levels of antibiotic resistance," Senanayake noted.

The team also found resistance levels were higher when healthcare was performed by the private sector.

"This may be because clinicians in the private health system are subject to fewer controls when it comes to both the volumes and types of antibiotics used," Senanayake emphasised.

Poorer countries should not regard antibiotic resistance as an inevitable consequence of their financial situation, noted co-researcher professor Premachandra Athukorala.

"If governance and corruption issues can be better addressed, it is very likely that major reductions in levels of antibiotic resistance will result - this will also lead to many other benefits worldwide," he pointed out.

Antimicrobial resistance is an urgent global health priority.

The World Health Organisation (WHO) describes it as a looming crisis in which common and treatable infections are becoming life threatening.

The research suggests that addressing corruption and control of antibiotics could help lower antibiotic resistance and save lives.