The World Health Organization details the issue of antimicrobial resistance and sets out the actions that need to be taken to reduce the threat.
Driven by the misuse and overuse of antimicrobials, antimicrobial resistance (AMR) is one of the top global public health and development threats. AMR is a problem for all countries at all income levels and tackling it requires the efforts of everyone across the globe.
The complexity of the AMR issue means that it requires both sector-specific actions in the human health, food production, animal and environmental sectors, and a co-ordinated approach across these sectors. During the 2015 World Health Assembly, countries adopted the Global Action Plan (GAP) on AMR with a commitment to the development and implementation of multisectoral national action plans with a One Health approach to tackle AMR. One Health refers to an integrated, unifying approach that aims to achieve optimal and sustainable health outcomes for people, animals, and ecosystems. The GAP was subsequently endorsed by the Governing Bodies of the Food and Agriculture Organization of the United Nations (FAO), the World Organisation for Animal Health (WOAH, formerly known as OIE), and the United Nations Environment Program (UNEP).
To learn more about the severity of the AMR threat and what actions can be taken by us all to reduce it, The Innovation Platform spoke to the World Health Organization.
How much of a global burden is AMR?
Antimicrobial resistance is a major global threat, putting modern medicine, food supplies and economies at risk. The emergence and spread of drug-resistant microbes threaten our ability to treat common infections and conduct life-saving procedures like chemotherapy, caesarean sections, organ transplants, and other routine procedures.
It is estimated that bacterial AMR alone is the direct cause of more than 1.25 million global deaths and a contributing factor to approximately five million deaths per year.
Although AMR is a challenge that affects countries in all regions and of all income levels, low- and middle-income countries (LMICs) are more affected, as health systems are less able to prevent, diagnose, and treat infections. Limited access to affordable vaccines, antimicrobial medicines and diagnostics, as well as lack of clean water, sanitation and hygiene (WASH) and poor infection prevention and control, also increase the threat of AMR.
The World Bank estimates that, by 2030, AMR is expected to cause a yearly global economic loss of up to $3.4tn, and that associated costs are expected to push 28 million people into extreme poverty.
What is driving the increase in AMR?
The spread of AMR is largely driven by the overuse and misuse of antimicrobials in human and animal health, as well as in agriculture.
When antimicrobials are used incorrectly or excessively, resistant microbes emerge and spread, making that specific antimicrobial ineffective against subsequent infections caused by those microbes. The result is that another antimicrobial must then be used, which, if again, overused or misused, may result in further resistance, leading to fewer or no options for treating that infection.
It is a vicious cycle, and one that is speeding up. Since the 1930s, the introduction of new antibiotics has been followed by the emergence of resistance, usually within a decade. Whereas, since the 1980s, the emergence of resistance now tends to happen faster, usually within three years. This can be due to a number of factors, including increased antibiotic use, globalisation and travel, environmental contamination, inadequate infection control, the lack of antibiotics, and the rapid adaptability of bacteria.
Meanwhile, the pipeline of new antibiotics is drying up; only 13 new antibiotics were introduced to the market between 2017 and 2023. In part, due to low profitability but also high development costs, regulatory challenges, and bacterial adaptation.
Difficulties in vaccine development also arise from scientific complexity, rigorous testing requirements, funding shortfalls, public perception issues, and unfavourable market dynamics.
Other factors which contribute to the spread of AMR include poor infection and disease prevention; limited awareness and training on AMR among key stakeholders; and lack of enforcement of relevant laws and policies. A lack of investments in strengthening primary healthcare in most LMICs, supporting veterinary services, and enhancing bio-security measures in animal food production also contribute to the AMR challenge.
How is the WHO working to tackle the issue of antimicrobial resistance? How are you collaborating with other organisations to do so?
WHO, the Food and Agriculture Organization of the United Nations (FAO), the UN Environment Programme (UNEP), and the World Organisation for Animal Health (WOAH) have joined forces to respond to AMR through a ‘One Health’ approach, covering human, animal, food security, and environmental health.
Known as the Quadripartite, the four organisations, co-ordinated through a Joint Secretariat hosted by WHO, collaborate on global advocacy, technical guidance, and political engagement to address the threat of AMR.
WHO developed the Strategic and operational priorities to address drug-resistant infections in the human health sector, 2025-2035. These priorities provide a guiding framework for accelerated national and global actions, aligned with strategies developed by WHO regional offices, and based on a people-centred approach and core package of interventions.
WHO also collaborates with a range of stakeholders to strengthen global AMR surveillance to enhance the accuracy and reliability of AMR estimates. This data-driven approach improves accountability and supports countries in tracking their progress against national action plans. They can also track progress against the UN SDG indicator ( 3.d.2) that tracks blood-stream infections due to two drug-resistant pathogens.
By providing guidance, tools and technical support to national public health authorities, WHO also supports countries to implement National Action Plans to curb the spread of AMR.
What is needed to hit the target of a 10% reduction in human deaths from AMR by 2030? Is it looking like a feasible target currently?
Achieving a 10% reduction in human deaths from AMR by 2030 will require strong commitment and accelerated, co-ordinated action. Following the recent High-Level Meeting on AMR at the UN General Assembly, leaders at the 79th UN General Assembly must now translate the commitments in the political declaration into action across human health, agriculture, and environmental sectors. This includes securing sustainable financing, with a goal of mobilising at least $100m to support national AMR action plans, particularly in low- and middle-income countries.
Essential actions include improving infection prevention, enhancing surveillance, and promoting antimicrobial stewardship to ensure appropriate use of medicines. Expanding the One Health model to address environmental factors is also critical, as is embedding AMR efforts within broader public health frameworks achieving Universal Health Coverage, through strengthening primary healthcare.
It looks like a feasible target based on a modelling exercise undertaken by Lewnard et al. 2024, Mendelson et al. 2024 as part of The Lancet Series on Antimicrobial Resistance: The need for sustainable access to effective antibiotics.
National action plans enumerate many interventions as potential strategies to reduce the burden of bacterial antimicrobial resistance (AMR). In a modelling analysis, the authors estimated that improving infection prevention and control programmes in low-and middle-income healthcare settings could prevent at least 337,000 (95% CI 250,200-465,200) AMR-associated deaths annually. Ensuring universal access to high-quality water, sanitation, and hygiene services would prevent 247,800 AMR-associated deaths. Additionally, paediatric vaccines would prevent another 181,500 AMR-associated deaths. This can be achieved from both direct prevention of resistant infections and reductions in antibiotic consumption.
These estimates translate to prevention of 7.8% (5.6–1.0) of all AMR-associated mortality in LMICs by infection prevention and control, 5.7% (3.7–8.0) by water, sanitation, and hygiene, and 4.2% (3.4–5.1) by vaccination interventions. Their findings indicate that reducing global AMR burden by 10% by the year 2030 is achievable with existing interventions – but these prevention strategies must be complemented by greater efforts to establish national structures to optimise the use of antimicrobials, greater awareness and training, and ensuring access to basic health services, timely diagnosis, and safe and quality-assured medicines.
Please note, this article will also appear in the 20th edition of our quarterly publication.
