Drug resistance is an extremely serious problem that is today undermining effective health care for millions of people and threatens to grow worse - yet it doesn’t receive serious attention. On a technical level, this is because drug efficacy is a common property resource - one that is difficult to bar people from using, but that does run out if we overuse it. We all want to believe that the drugs we rely upon will keep working no matter how much we use them - or misuse them. Further, many actors make decisions that determine the trajectory of drug resistance that impose invisible costs to society, thereby lulling us into complacency.

On a human level, it is hard to see that people are dying from drug resistance - but they are. As with climate change, we now understand the science of drug resistance well enough to act, but the policy response has eluded us.

Resistance to drugs also has a startling impact on the cost of curing patients. In many poor countries, expenditures for drugs represent a large proportion of overall health-care costs, ranging from 20 to 60 percent of total expenditure on health. When first-line drugs fail, second-line alternative drugs are almost always far more costly and require greater medical oversight. For example, it costs as much to cure one patient of extensively drug-resistant TB as it does to cure 200 patients of susceptible TB.