DEMOGRAPHIC, MEDICAL, AND SOCIAL DIMENSIONS OF POPULA-TION HEALTH IN THE ERA OF ANTIBIOTIC RESISTANCE

Abstract

Background. Antimicrobial resistance (AMR) undermines the effectiveness of anti-infective treatments and substantially contributes to preventable losses of healthy life years. Its impact is increasingly correlated with global indexes of health and human development, such as HALE (Healthy Life Expectancy), DALY (Disability-Adjusted Life Years), and HDI (Human Development Index).

Objective. To assess the relationship between AMR and population health performance using HALE, DALY, and HDI in the Republic of Moldova, Romania, Ukraine, and the European Union average, with the aim of supporting the development of a national composite monitoring tool—an AMR Index.

Methods. This secondary study applied a narrative synthesis methodology, drawing on data extracted from official and validated repositories (WHO, IHME, UNDP, Eurostat) and recent scientific literature (2015–2025), combined with a regional comparative analysis. Correlation plots and standardized tables were used to report HALE, DALY per 100,000 population, and HDI scores, alongside data on antibiotic consumption and the level of implementation of antimicrobial stewardship policies.

Results. The Republic of Moldova records a HALE of 64.3 years (vs 71.3 in the EU), a DALY burden exceeding 36,000 per 100,000 population, and an HDI of 0.767, indicating high vulnerability to the impact of AMR. These values are negatively influenced by unregulated access to antibiotics, low levels of health literacy, and insufficient microbiological diagnostic infrastructure. The study confirms a negative AMR–HALE correlation, a positive AMR–DALY correlation, and an indirect effect on HDI, consistent with recent European evidence.

Conclusion. AMR exerts a multidimensional impact on population health and human development, which requires its integration into national monitoring systems. A national AMR Index is proposed to integrate epidemiological data, socio-health indicators, and governance components to guide One Health policies and align with the priorities of the 2030 Agenda for Sustainable Development.