Over the past few years, many in the infection control community have identified global antimicrobial resistance as the classic economic problem known as ‘tragedy of the commons.’ Tragedy of the commons refers to the situation in which many uncoordinated players, acting in their own self interest, deplete a limited shared resource. Seminal examples include overfishing the ocean and global warming.
Antimicrobial resistance is similar in that health care providers and patients, acting in their own self interest, behave rationally and consume increasing amounts of antibiotics. This drives the unintended, adverse result of increasing antimicrobial resistance, compromising the efficacy of those same antibiotics. 60% of staphylococcus aureus in the US and UK are methicillin resistant. Multi-drug resistance pathogens are emerging in developing countries partially as a result of antibiotic overuse.
Recognizing that antimicrobial resistance is a global economic problem as well as a public health problem better informs strategies and solutions. We begin to think of antibiotic efficacy as a shared limited resource - like the environment and the world's fisheries, and can exercise innovative solutions to promote desirable behavior. Here are experts who've framed the problem in this way:
The tragedy of antimicrobial resistance: achieving a recognition of necessity
Antibiotic Overuse: The Influence of Social Norms
The sounds of silence: Public goods, externalities, and the value of infectious disease control programs