Antibiotic Resistance: 1.9 Million Deaths a Year by 2050

Antibiotic resistance is not a future threat. It is killing people now. In 2019, drug-resistant bacteria were directly responsible for 1.27 million deaths. They contributed to 4.95 million more. That is more than HIV and malaria combined. (Source: The Lancet, GRAM Project, September 2024)

The numbers are getting worse, not better. Australia’s own data shows critical antimicrobial resistances jumped 25 per cent in a single year. (Source: AURA Sixth Report, February 2026)

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The Scale

The most comprehensive study ever conducted on antibiotic resistance was published in The Lancet in September 2024. The Global Research on Antimicrobial Resistance (GRAM) Project analysed 204 countries over 31 years. The findings:

1.27 million direct deaths in 2019. 1.14 million in 2021. By 2050, the projection is 1.91 million direct deaths per year, with 8.22 million associated deaths. Cumulative deaths between 2025 and 2050: 39 million. (Source: The Lancet, GRAM 2024; IHME)

The widely cited “10 million deaths by 2050” figure comes from a 2016 UK review. The GRAM 2024 study is more rigorous. The corrected figure of 1.91 million is lower. It is still a catastrophe. (Source: O’Neill Review 2016; Nature, September 2024)

Deaths among children under five dropped 50 per cent between 1990 and 2021. Deaths among adults aged 70 and over increased by more than 80 per cent. (Source: Lancet GRAM 2024)

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Where the Antibiotics Go

Seventy per cent of global antibiotics go to farm animals. Not to hospitals. Not to sick people. To livestock. (Source: FAIRR Initiative, February 2026; Our World in Data, December 2024)

The trajectory is alarming. A study published in Nature Communications in April 2025 projects that under business as usual, global livestock antibiotic use will rise to 143,481 tonnes by 2040. That is a 30 per cent increase from 2019 levels. (Source: Nature Communications, April 2025; FAO)

In the United States, sales of medically important antibiotics for livestock surged 16 per cent in 2024. The largest annual increase recorded. (Source: US FDA, 2025)

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Countries That Fixed It

It can be done. The Netherlands cut veterinary antibiotic use by 76 per cent between 2009 and 2024. The government banned preventive use of all antimicrobials in animals in 2011. Every farm’s antibiotic use was benchmarked against its peers. Outliers faced regulatory action. The Netherlands is one of the most intensive agricultural producers in Europe. Its farms did not collapse. (Source: Dutch Government; Pig Progress, October 2025)

Denmark banned growth-promoting antibiotics in the late 1990s. Total antibiotic use in livestock fell by more than half. Livestock production increased after the ban. The DANMAP programme, established in 1995, became the global model for integrated surveillance. (Source: PMC; Pew Charitable Trusts, 2010)

Sweden has among the lowest antibiotic consumption rates in the world. Its STRAMA programme, founded in 1995, uses physician-led stewardship rather than top-down mandates. (Source: PMC, 2017)

A global study by the Stockholm Resilience Centre in April 2025 confirmed that countries can reverse increasing antibiotic resistance. By 2023, Japan, France, and Malaysia had joined the list of countries showing measurable improvement. (Source: Stockholm Resilience Centre, April 2025)

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Australia’s Problem

Australia has one of the highest rates of community antibiotic prescribing in the developed world. It ranks 7th highest among 28 European and European Economic Area countries. Its rate is approximately 75 per cent above the OECD average. (Source: AURA 2021; OECD Health at a Glance 2025)

In 2024, 23.2 million antibiotic prescriptions were supplied under the PBS. That was up 4.8 per cent on the previous year. More than a third of the population, 37.1 per cent, had at least one antimicrobial dispensed. (Source: AURA Sixth Report, February 2026)

Less than half, 45 per cent, of antibiotics given after surgeries were prescribed appropriately. More than half of surgical prophylaxis antibiotic use is inappropriate. (Source: AURA Sixth Report; RACGP, February 2026)

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The Agricultural Gap

Australia has banned antibiotic growth promotants in intensive livestock. Fluoroquinolones and colistin are not approved for food-producing animals. These are genuine protections.

But there is no legal ban on using antibiotics as preventive treatments in animals. The Netherlands banned this in 2011. The EU banned it in 2022. Australia has not.

Australian poultry uses 299 milligrams of antibiotics per kilogram of livestock. The UK uses 16 milligrams per kilogram. That is 18 times more per animal. The Australian pig industry uses roughly three times more than British pig farmers. (Source: Alliance to Save Our Antibiotics, UK Parliament Evidence, 2020)

Australia’s overall “low use” ranking is partly structural. The extensive cattle industry, where animals graze on vast stations, uses very few antibiotics. The poultry and pig sectors tell a different story. (Source: Grok Research analysis; Animal Health Australia)

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The People It Hurts Most

In remote Indigenous communities, MRSA rates exceed 50 per cent of all Staphylococcus aureus isolates. That means more than half of golden staph infections cannot be treated with standard antibiotics.

Aboriginal people are 12.3 times more likely to develop MRSA septicaemia than non-Indigenous Australians. Aboriginal people comprised 89 per cent of patients with non-multiresistant MRSA in Central Australian data. (Source: Doherty Institute; OECD, September 2024)

The OECD published a dedicated 91-page report in September 2024: “Tackling antimicrobial resistance in Indigenous, rural and remote communities.” The Medical Journal of Australia published an urgent call for antimicrobial stewardship in Indigenous primary health care in 2019.

Remote Indigenous communities are not mentioned in the current National AMR Strategy. (Source: Doherty Institute; MJA 2019; CSIRO)

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The Industry Pushback

The DeSmog investigative journalism outlet documented in December 2023 how the animal pharmaceutical industry employs six “narratives of delay” to weaken regulation: questioning the science, claiming voluntary measures are sufficient, arguing for longer transition periods, warning of economic harm, shifting blame to other sectors, and claiming existing regulations are adequate. (Source: DeSmog, December 2023)

The Changing Markets Foundation identified in July 2024 that 22 major meat and dairy companies use “Big Tobacco tactics” to block antibiotic regulation: “distract, delay, and derail.” (Source: Changing Markets Foundation, July 2024)

The pharmaceutical industry argues that the antibiotic development pipeline is broken by economics. A new antibiotic costs approximately $1.5 billion to develop but generates only $50 million in annual revenue, because new antibiotics are reserved as last-resort treatments. (Source: PMC; Brookings Institution)

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The Other Side

Industry groups argue that restricting antibiotics in farming compromises animal welfare. Sick animals need treatment. Intensive farming requires antibiotics to prevent disease outbreaks that could devastate entire herds or flocks.

The agricultural industry points out that global antimicrobial use in animals declined 13 per cent over three years, according to the World Organisation for Animal Health. They argue the link between agricultural antibiotic use and human resistance is not as direct as claimed.

The pharmaceutical industry advocates for “subscription-style” payments, where governments pay a fixed annual fee for access to new antibiotics regardless of how much is used. The UK has pioneered this model. Australia’s AMR Pricing and Reimbursement Scoping Study examined similar models in March 2025. (Source: WOAH; AMR.gov.au)

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The Way Forward

In September 2024, 193 member states of the United Nations committed to a 10 per cent reduction in global AMR-related deaths by 2030. Critics called the target insufficient and the $100 million in catalytic funding inadequate. (Source: UN General Assembly, September 2024; ReAct Group)

The WHO draft updated Global Action Plan on AMR, released in January 2026, sets targets for reducing antimicrobial use in the agri-food system and environmental release by 2030. (Source: WHO, January 2026)

For Australia, the evidence points to specific actions: ban preventive antibiotic use in animals as the EU and Netherlands have done, implement farm-level usage benchmarking, fund antimicrobial stewardship in remote Indigenous communities, reduce community prescribing through GP education and patient awareness, and invest in new antibiotic development through subscription-style payment models.

The solutions exist. Denmark and the Netherlands proved they work. The gap is between knowing what to do and doing it.

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Sources

• Lancet GRAM 2024: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01867-1/fulltext
• IHME AMR data: https://www.healthdata.org/research-analysis/health-topics/antimicrobial-resistance-amr
• WHO AMR Fact Sheet: https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance
• AURA Sixth Report: https://www.amr.gov.au/sites/default/files/2026-02/sixth-australian-report-on-antimicrobial-use-and-resistance-in-human-health-aura-report_0.pdf
• Nature Communications livestock projections: https://www.nature.com/articles/s41467-025-56825-7
• DeSmog Narratives of Delay: https://www.desmog.com/2023/12/20/narratives-of-delay-how-the-animal-pharma-industry-resists-moves-to-curb-the-overuse-of-antibiotics-on-farms/
• OECD Indigenous AMR: https://www.oecd.org/content/dam/oecd/en/publications/reports/2024/09/tackling-antimicrobial-resistance-in-indigenous-rural-and-remote-communities_d81907a6/349bc0fc-en.pdf
• Doherty Institute remote communities: https://www.doherty.edu.au/articles/antibiotic-resistance-greater-challenge-in-remote-indigenous-communities/
• Dutch antibiotic reduction: https://www.pigprogress.net/specials/antibiotic-reduction-in-the-netherlands-from-challenge-to-leading-example/
• DANMAP: https://www.danmap.org/
• Stockholm Resilience Centre: https://www.stockholmresilience.org/research/research-stories/2025-04-30-every-action-counts-global-study-shows-countries-can-reverse-increasing-antibiotic-resistance.html
• UK Parliament poultry evidence: https://committees.parliament.uk/writtenevidence/12245/html/
• UN AMR Declaration: https://www.un.org/pga/wp-content/uploads/sites/108/2024/09/FINAL-Text-AMR-to-PGA.pdf