Hollis, AidanRahman, Sakib2023-08-242023-08-242023-08Rahman, S. (2023). The silent pandemic: essays on the interplay of antimicrobial use, resistance and external cost (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.https://hdl.handle.net/1880/116898https://dx.doi.org/10.11575/PRISM/41740The aim of this thesis is to take an economist’s perspective on antimicrobial resistance (AMR). AMR, now framed as a silent pandemic, is a natural response of microbes brought upon by selective pressure from using antimicrobials. Several controllable factors, primarily the extensive and continuous usage of antimicrobials, are hastening the increase of resistance. Therefore, it is crucial to understand the magnitude and duration of how antimicrobial usage effects resistance. The first two chapters of this thesis use empirical methodologies developed in the field of economics to analyze the causal relationship between usage and resistance. The chapters use comprehensive longitudinal public and proprietary data from Europe for empirical analysis. The first chapter, with usage and resistance data only for humans, finds that the prevalence of resistant bacteria rapidly rises following antibiotic usage and continues to rise for a minimum of four years thereafter. Strikingly, reducing antibiotic usage has minimal discernible effect on resistance. The second chapter studies the same relationships for food-producing animals and humans. Using a One-health perspective the study finds that antibiotic usage in food-producing animal and antibiotic usage in humans are independently and causally related to the prevalence of resistance in both humans and other animals. The third chapter frames AMR as an externality associated with AMU, and using new elasticity measures explores the external cost of AMU and potential policy responses.enUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.antimicrobialresistanceusageexternalityeconomic costtaxOne HealthhumansanimalsEducation--Social SciencesEconomicsEducation--HealthPublic HealthEpidemiologydoctoral thesis