The CDDEP report isn’t silent on the science and also goes into detail on how antibiotic use in livestock can affect humans. Per capita use in these countries is still less than half of what it is in the United States but the increase, driven by growing prosperity, includes a great deal of unnecessary and inappropriate use. In many countries, antibiotics are easily purchased in pharmacies and shops without prescription.

The findings on antibiotic resistance were released through an interactive online tool that allows users to track the latest global trends in drug resistance in 39 countries, and antibiotic use in 60 countries. “The greater the volume of antibiotics used, the greater the chances that antibiotic-resistant populations of bacteria will prevail…”

Global antibiotic consumption grew by 30% between 2000 and 2010. Though wealthy countries still use far more antibiotics per capita, high rates in the low and middle-income countries like India, Kenya and Vietnam for which surveillance data is now available sounds a warning to the world.

Globally, up to 50% of antibiotic use outside hospitals is inappropriate – either the wrong drug is used, the wrong duration is specified, incorrect dose of the drug is prescribed or antibiotics are given for viral infections for which they can do nothing about. Additionally, a proportion of the antibiotics used in both agriculture and aquaculture end up in the environment adding to the “total global burden of antibiotic resistance in both animals and humans”. We are not investing the kinds of money we need to to conserve the effectiveness of antibiotics and to change the system of incentives in which we are using them. “Antibiotic resistance doesn’t have to be an evergreen problem”. Some of those measures, such as improving sanitation, are obvious, whereas policies that restrict antibiotic use in agriculture and hospitals might be more difficult or controversial to implement. The nation is also second to China in its consumption of antibiotics in livestock.

That means vaccines and clean water to keep people from getting sick in the first place, not giving antibiotics for colds willy nilly, and cutting down on antibiotic use in animals. For three different drug classes, E Coli resistance in India is presently over 80%.

In India, for instance, the number of Klebsiella pneumoniaeinfections that are resistant to a class of powerful antibiotics called carbapenems doubled from 29% in 2008 to 57% in 2014. At least 55% of the samples from India, which were tested in 2014, were resistant, a significant increase from almost zero in 2000. The super bug found in hospitals is around 80 percent resistance to the drug class third generation cephalosporins, 73 per cent resistant to fluoroquinolones, and 63 percent to aminoglycosides. For comparison, these drugs, are still effective against Klebsiella infections in 90% of cases in USA and over 95% of cases in Europe.

“Much of this data has never seen the light of day before because we dug it out from private clinics in these middle-income countries like India”, says Ramanan Laxminarayan of the Center for Disease Dynamics, Economics and Policy in New Delhi, India. And 41 percent of those surveyed said they had heard only a little, or nothing at all, about antibiotic resistance.

It’s a pretty serious problem, and the agricultural use of antibiotics plays a large part. The study found that the bacteria k. pneumoniae, which can cause damage to the lungs, has developed huge resistance to the antibiotic ampicillin, particularly in Asia and Africa, where the median resistance ranged from 94 to 100 percent.

The report also notes that the prevalence of the MRSA superbug, which can be resistant to even last-resort antibiotics and contracted in hospitals, has dropped in recent years in South Africa. But MRSA is on the rise in other parts of the world, including India, Australia, and Latin America.

The report advises that limiting overuse and misuse of antibiotics are the only sustainable solutions. R Laxminarayan, CDDEP director and report co-author said, “Rampant rise in anti biotic use poses a major threat o public health, especially when there’s no oversight on appropriate prescribing”. “Our lives depend on it and we know so little about it”.