Antibiotic use across the world has jumped by one sixth since 2016, a new study has found, despite continuing concerns that their overuse is leading to the spread of resistant bacteria.
The new research highlights Kuwait as the country with the biggest drop in antibiotic use between 2016 and 2023, while some other nations from the region, including the UAE, have registered increases. Many of the biggest rises in antibiotic use have been in lower and upper middle-income countries and regions, among them Thailand, Central America, West Africa and China.
Published last month [November] in the journal PNAS Environmental Sciences, the study looked at dozens of countries and regions across the world and found that between 2016 and 2023, estimated antibiotic consumption increased 16.3 per cent from 29.5 billion to 34.3 billion defined daily doses. Dr Eili Klein, a senior fellow at the One Health Trust and the first author of the study, told The National that several factors were driving the increase in antibiotic use in middle-income countries.
“The primary reason is economic in nature; in expanding economies individuals can afford a wider range of goods, including better access to health care,” he said. “However, rapid economic growth often outpaces infrastructure development, resulting in inadequate hygiene and sanitation, which can lead to increased rates of infection, which can in turn lead to increased antibiotic use.”
Global issue
Every year well over one million people die because of antimicrobial resistance (AMR), according to the World Health Organisation, with increasing resistance among bacteria to antibiotics the key concern. This occurs when bacteria or other pathogens evolve and no longer respond to antibiotics.
There may be more than 39 million deaths by 2050 because of increased resistance to antibiotics in bacteria, according to a study published this year in The Lancet. Resistance to antibiotics makes common medical procedures such as surgery and the administering of cancer chemotherapy riskier, because any infections that result become harder to treat.
Dr Bharat Pankhania, a senior clinical lecturer in the University of Exeter Medical School in the UK, said there was a problem with antibiotic use “locally, nationally and internationally”.
“They shouldn’t be available over-the-counter and they should be prescribed by people who know about them: the right antibiotic for the right infection,” he said.
Regional impact
While the study indicated a modest increase in antibiotic consumption in the UAE between 2016 and 2023 of up to or less than 10 per cent, a standout finding was that in the same period, antibiotic consumption in Kuwait, which like the UAE was classed as a high-income country in the study, appeared to have dropped significantly, by about 40 per cent.
Dr Averyan Vasylyev, Gulf medical director for GSK, one of the few large pharmaceutical companies still working on developing new antibiotics, said his firm’s data did not indicate that Kuwait had recorded a significant drop in antibiotic use.
“We do not observe the same pattern from the market itself and from the market intelligence that we have access to, neither do we see any change in the pattern from the sales of the antibiotics,” he told The National. “I would not think that that [result in the study] would be the actual case in the clinical practice.”
He said the study did not focus on hospital use of antibiotics in the country, which is where “80 to 90 per cent of the consumption is”.
Saudi Arabia was also recorded in the study as having experienced a drop in antibiotic use, in the low single-digits in percentage terms. Dr Vasylyev said in the UAE there was detailed data available on prescription patterns, even down to the level of the individual hospital, and that doctors were well trained.
“I would say that the situation here, if you compare it to some other countries across emerging markets, is … well developed,” he added.
Public prevention
There are things the public can do to prevent the spread of antimicrobial resistance, Dr Vasylyev said, including ensuring they do not stop taking antibiotics earlier than the prescription from the physician suggests.
Stopping antibiotics early has been blamed for infections coming back and for the spread of resistant forms of bacteria. It is also important, Dr Vasylyev indicated, for people not to use leftover antibiotics at a future time when they believe they need them.
“So many people just store the leftovers and then whenever they have similar symptoms they open the freezer and take the antibiotic while they have, for example, a viral infection. That's very common,” he said.
Among high-income nations, those successful at limiting their use of antibiotics had “followed a holistic approach” that includes building and supporting antimicrobial stewardship programmes, improving infection prevention, restricting access to antibiotics and running public awareness campaigns, Dr Klein said.
In middle-income countries, a range of measures can reduce antibiotic use, he said, including improving access to routine preventive health care, such as vaccines to prevent disease.
“Additional investments are needed in antimicrobial stewardship, including messaging to patients, physicians and pharmacists, to avoid inappropriate use,” he said.
This is not just about avoiding antibiotics when not needed, but also ensuring their use is more tailored to the infection, such as by prescribing narrower-spectrum antibiotics and reducing prescription duration. Countries should also, he suggested, invest in surveillance so that prescribing patterns are well understood and programmes to optimise them can be developed. There is, Dr Klein said, “no silver bullet strategy”.
“The most interesting results, though, suggest that cultural differences in care-seeking and patient demand for antibiotics may be one of the most important factors, and altering cultural perceptions is difficult,” he said.
5 of the most-popular Airbnb locations in Dubai
Bobby Grudziecki, chief operating officer of Frank Porter, identifies the five most popular areas in Dubai for those looking to make the most out of their properties and the rates owners can secure:
• Dubai Marina
The Marina and Jumeirah Beach Residence are popular locations, says Mr Grudziecki, due to their closeness to the beach, restaurants and hotels.
Frank Porter’s average Airbnb rent:
One bedroom: Dh482 to Dh739
Two bedroom: Dh627 to Dh960
Three bedroom: Dh721 to Dh1,104
• Downtown
Within walking distance of the Dubai Mall, Burj Khalifa and the famous fountains, this location combines business and leisure. “Sure it’s for tourists,” says Mr Grudziecki. “Though Downtown [still caters to business people] because it’s close to Dubai International Financial Centre."
Frank Porter’s average Airbnb rent:
One bedroom: Dh497 to Dh772
Two bedroom: Dh646 to Dh1,003
Three bedroom: Dh743 to Dh1,154
• City Walk
The rising star of the Dubai property market, this area is lined with pristine sidewalks, boutiques and cafes and close to the new entertainment venue Coca Cola Arena. “Downtown and Marina are pretty much the same prices,” Mr Grudziecki says, “but City Walk is higher.”
Frank Porter’s average Airbnb rent:
One bedroom: Dh524 to Dh809
Two bedroom: Dh682 to Dh1,052
Three bedroom: Dh784 to Dh1,210
• Jumeirah Lake Towers
Dubai Marina’s little brother JLT resides on the other side of Sheikh Zayed road but is still close enough to beachside outlets and attractions. The big selling point for Airbnb renters, however, is that “it’s cheaper than Dubai Marina”, Mr Grudziecki says.
Frank Porter’s average Airbnb rent:
One bedroom: Dh422 to Dh629
Two bedroom: Dh549 to Dh818
Three bedroom: Dh631 to Dh941
• Palm Jumeirah
Palm Jumeirah's proximity to luxury resorts is attractive, especially for big families, says Mr Grudziecki, as Airbnb renters can secure competitive rates on one of the world’s most famous tourist destinations.
Frank Porter’s average Airbnb rent:
One bedroom: Dh503 to Dh770
Two bedroom: Dh654 to Dh1,002
Three bedroom: Dh752 to Dh1,152
Our legal consultant
Name: Dr Hassan Mohsen Elhais
Position: legal consultant with Al Rowaad Advocates and Legal Consultants.
Benefits of first-time home buyers' scheme
- Priority access to new homes from participating developers
- Discounts on sales price of off-plan units
- Flexible payment plans from developers
- Mortgages with better interest rates, faster approval times and reduced fees
- DLD registration fee can be paid through banks or credit cards at zero interest rates
Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.
Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.
“Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.
Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.
“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.
Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.
From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.
Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.
BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.
Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.
Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.
“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.
Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.
“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.
“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”
The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”
Timeline
2012-2015
The company offers payments/bribes to win key contracts in the Middle East
May 2017
The UK SFO officially opens investigation into Petrofac’s use of agents, corruption, and potential bribery to secure contracts
September 2021
Petrofac pleads guilty to seven counts of failing to prevent bribery under the UK Bribery Act
October 2021
Court fines Petrofac £77 million for bribery. Former executive receives a two-year suspended sentence
December 2024
Petrofac enters into comprehensive restructuring to strengthen the financial position of the group
May 2025
The High Court of England and Wales approves the company’s restructuring plan
July 2025
The Court of Appeal issues a judgment challenging parts of the restructuring plan
August 2025
Petrofac issues a business update to execute the restructuring and confirms it will appeal the Court of Appeal decision
October 2025
Petrofac loses a major TenneT offshore wind contract worth €13 billion. Holding company files for administration in the UK. Petrofac delisted from the London Stock Exchange
November 2025
180 Petrofac employees laid off in the UAE
UK%20-%20UAE%20Trade
%3Cp%3ETotal%20trade%20in%20goods%20and%20services%20(exports%20plus%20imports)%20between%20the%20UK%20and%20the%20UAE%20in%202022%20was%20%C2%A321.6%20billion%20(Dh98%20billion).%C2%A0%3C%2Fp%3E%0A%3Cp%3E%3C%2Fp%3E%0A%3Cp%3EThis%20is%20an%20increase%20of%2063.0%20per%20cent%20or%20%C2%A38.3%20billion%20in%20current%20prices%20from%20the%20four%20quarters%20to%20the%20end%20of%202021.%3C%2Fp%3E%0A%3Cp%3E%C2%A0%3C%2Fp%3E%0A%3Cp%3EThe%20UAE%20was%20the%20UK%E2%80%99s%2019th%20largest%20trading%20partner%20in%20the%20four%20quarters%20to%20the%20end%20of%20Q4%202022%20accounting%20for%201.3%20per%20cent%20of%20total%20UK%20trade.%3C%2Fp%3E%0A
