The increasing resistance of bacteria to antibiotics, and pests to pesticides, threatens to undo some of the most remarkable advances made in public health and agriculture during the past century. Though the potential consequences of increased antibiotic and pesticide resistance are far reaching, regulatory efforts to address the problem are at a very early stage. Battling Resistance to Antibiotics and Pesticides moves such discussions forward by presenting cutting edge research and the first comprehensive application of economic tools to analyze how antibiotics and pesticides should be used to maximize their value to society. Laxminarayan and his contributors explore lessons from past experiences with resistance, especially in agriculture. They consider what incentives would be ideal for the individuals who prescribe or apply antibiotics and pesticides, and what would be ideal for the firms engaged in developing and producing these products. The chapters in this groundbreaking book reflect the fact that efforts to combat resistance will require contributions from a broad range of scholars and professionals, representing a broad range of expertise. The analysis demonstrates that, for all these participants, an understanding of economic issues is an essential complement to knowledge of medical or biological factors. The book provides economists with an overview of relevant scientific issues, as well as a variety of analytical approaches to studying the economics of resistance. It offers policymakers detailed analyses of the multiple dimensions of resistance and discusses the future strategies to combat and manage resistance. For professionals in medicine, public health, and agriculture, the book translates the economic approaches into usable guidance for daily practice and decisionmaking.
Table of Contents
Contributors About This Book Introduction: On the Economics of Resistance PART I. Issues of Optimal Management of Resistance 1. Dynamics of Antibiotic Use: Ecological versus Interventionist Strategies To Manage Resistance to Antibiotics James E. Wilen and Siwa Msangi 2. Using Antibiotics When Resistance Is Renewable Robert Rowthorn and Gardner M. Brown 3. Value of Treatment Heterogeneity for Infectious Diseases Ramanan Laxminarayan and Martin L. Weitzman Commentary: To Take or Not to Take the Antibiotic? James N. Sanchirico Commentary: Same Infection, Same Time, Same Antibiotic? Stephen W. Salant 4. Pest Mobility, Market Share, and the Efficacy of Refuge Requirements for Resistance Management Silvia Secchi and Bruce A. Babcock Commentary: Need for Direct Collaboration between Economists and Biologists Fred Gould PART II. The Impact of Resistance 5. The Impact of Resistance on Antibiotic Demand in Patients with Ear Infection David H. Howard and Kimberly J. Rask Commentary: Measuring the Cost of Resistance Ramanan Laxminarayan 6. What Can We Learn from the Economics of Pesticides? Impact Assessment of Genetically Modified Plants Hermann Waibel, Jan C. Zadoks, and Gerd Fleischer Commentary: The Role of Ecosystem Complexity in Genetically Modified Organisms Karl Seeley 7. Elements of Economic Resistance Management Strategies Some Empirical Evidence from Case Studies in Germany Gerd Fleischer and Hermann Waibel Commentary: Can We Justify Resistance Management Strategies for Conventional Pesticides? Fred Gould 8. Pesticide Resistance, the Precautionary Principle, and the Regulation of Bt Corn: Real and Rational Option Approaches to Decisionmaking Beno t Morel, R. Scott Farrow, Felicia Wu, and Elizabeth A. Casman 9. Resistance Economics of Transgenic Crops under Uncertainty: A Real Option Approach Justus Wesseler Commentary: Economics of Transgenic Crops and Pesticide Resistance: An Epidemiological Perspective Christopher A. Gilligan PART III. The Behavior of Firms 10. An Economic Model of a Genetic Resistance Commons: Effects of Market Structure Applied to Biotechnology in Agriculture Douglas Noonan Commentary: Does the Monopolist Care about Resistance? Carolyn Fischer 11. The Interaction of Dynamic Problems and Dynamic Policies: Some Economics of Biotechnology Timo Goeschl and Timothy Swanson 12. Industrial Organization and Institutional Considerations in Agricultural Pest Resistance Management Jennifer Alix and David Zilberman Commentary: Strategic Issues in Agricultural Pest Management R. David Simpson Index About the Editor
Ramanan is a senior fellow at Resources for the Future in Washington, DC. His research includes the integration of epidemiological models of infectious disease transmission and the economic analysis of public health problems. He has worked with the World Health Organization on evaluating malaria treatment policy in Africa, and recently served on a National Academy of Science/Institute of Medicine Committee on the Economics of Anti-malarial Drugs. He teaches international health policy in the Johns Hopkins Bloomberg School of Public Health, and development economics at the Johns Hopkins University‘s Paul H. Nitze School of Advanced International Studies.
'...a welcome addition to the small existing literature on the effects of antibiotic and pesticide resistance. It provides a good review of both the analytical tools used to study the effects of resistance, as well as of the economic policy measures that might be available to fight resistance to antibiotics and pesticides.' Environment International 'Interesting and diverse, the contents reflect the beginnings of an economics of resistance that is likely to grow in importance.' Marc Lipsitch, Harvard School of Public Health