The headline forecast
The GRAM Project's 2024 study — the first analysis of AMR trends over time across 204 countries — forecasts that on current trends, deaths directly caused by bacterial AMR will climb from about 1.14 million in 2021 to 1.91 million per year by 2050, an increase of almost 70%. Deaths in which resistance plays a part are projected to reach 8.22 million per year by 2050.
Deaths directly attributable to bacterial AMR, past and forecast
Millions of deaths per year (GRAM Project, The Lancet, 2024; 2050 is a forecast)
The striped bar marks a forecast. The near-flat trend from 1990 to 2021 hides opposing currents: child deaths halved while deaths among over-70s rose more than 80%. Ageing populations drive the projected surge.
Where the deaths will fall
- South Asia is projected to bear the largest absolute toll, with tens of millions of deaths involving resistance between 2025 and 2050.
- Sub-Saharan Africa continues to suffer the highest death rates, compounded by limited access to second-line antibiotics.
- Older adults everywhere: most of the projected growth comes from people over 70, whose numbers and hospital contact are rising worldwide.
An earlier, widely cited projection — the UK's 2016 O'Neill Review — warned of up to 10 million deaths per year by 2050. The newer GRAM forecast is more conservative because it models trends pathogen by pathogen, but its cumulative message is the same: without intervention, the toll rises relentlessly.
The economic forecast
The costs of AMR extend far beyond hospitals: longer illnesses, costlier second-line drugs, lost productivity, riskier surgery, and shocks to trade in food and livestock.
In the World Bank's high-impact scenario, annual global GDP losses approach 3.8% by 2050 — economic damage on the scale of the 2008 financial crisis, but permanent and compounding. Crucially, the same analyses find that containment measures costing a few billion dollars a year would pay for themselves many times over.
The hopeful half of the forecast
The 2024 study modelled better futures, not just grim ones:
- Better care scenario: improving infection prevention, diagnosis and treatment quality — and getting existing antibiotics to those who need them — could save a cumulative 92 million lives between 2025 and 2050.
- New drugs scenario: developing effective new antibiotics against Gram-negative bacteria could save about 11 million lives over the same period.
In other words, the 39-million-death forecast is a choice, not a destiny. The levers exist; the following pages describe who is pulling them and how.
Bottom line
On current trends AMR kills almost 2 million people a year by 2050 and drains trillions from the world economy. But modelling shows most of that harm is preventable with tools we already have — if they are deployed widely and fast.
Sources for this page
- GBD 2021 Antimicrobial Resistance Collaborators, “Global burden of bacterial antimicrobial resistance 1990–2021: a systematic analysis with forecasts to 2050”, The Lancet, 2024 — thelancet.com/journals/lancet/article/PIIS0140-6736(24)01867-1/fulltext
- IHME press release, “More than 39 million deaths from antibiotic-resistant infections estimated between now and 2050”, 2024 — healthdata.org
- World Bank, “Drug-Resistant Infections: A Threat to Our Economic Future”, 2017 — worldbank.org
- Center for Global Development, “Forecasting the Fallout from AMR: Economic Impacts of Antimicrobial Resistance in Humans”, 2024 — cgdev.org
- Review on Antimicrobial Resistance (O'Neill Review), “Tackling Drug-Resistant Infections Globally”, 2016 — amr-review.org