Antimicrobial resistance (AMR) has emerged as one of the most formidable challenges to public health security worldwide, threatening the effectiveness of essential medical treatments and the management of infectious diseases. The relentless spread of resistant pathogens compromises the effectiveness of life-saving treatments, leading to longer hospital stays, higher medical costs, and increased mortality. This article delves into the profound and multifaceted impact of AMR, illustrating how it undermines the ability to treat common infections, perform routine surgeries, and manage chronic conditions. The vicious cycle of AMR not only exacerbates the burden on healthcare systems but also threatens to reverse decades of medical progress, potentially plunging the world into a post-antibiotic era where minor infections could once again be fatal. The article further explores the integral role of healthcare systems and policy frameworks in addressing this burgeoning crisis. It discusses how the lack of coordinated global strategies and inconsistent policy implementation have allowed AMR to flourish, emphasizing the need for robust healthcare infrastructures that prioritize the prevention and control of resistance. Critical measures such as enhancing global surveillance systems, promoting antimicrobial stewardship, and fostering innovation in new drug development are identified as pivotal in the fight against AMR. Moreover, the article highlights the importance of policy-driven interventions, including the enforcement of regulations on antibiotic use, investment in public health education, and the integration of AMR action plans into national health policies. By examining successful case studies and identifying gaps in current approaches, the article provides a comprehensive analysis of how healthcare systems and policy can be leveraged to combat AMR effectively. The discussion culminates in a call for a unified global response, underscoring that combating AMR requires not only technological advancements but also sustained political commitment and international collaboration to secure a safer, healthier future for all.
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Antimicrobial Resistance (AMR), Global Health Threats, Public Health Security, Multidrug-Resistant Organisms, Infection Control, Public Health Policy, Healthcare Systems, Antibiotic Stewardship
1. Introduction
Antimicrobial resistance (AMR) represents a rapidly increasing threat to global public health, posing significant challenges to the treatment of infectious diseases and the management of healthcare systems worldwide. AMR occurs when microorganisms—such as bacteria, viruses, fungi, and parasites—evolve mechanisms that protect them from the effects of antimicrobial drugs that were once effective
[1]
Antimicrobial Resistance Collaborators. (2022). Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. The Lancet; 399(10325): P629-655.
. This resistance can lead to treatment failures, prolonged illnesses, and increased mortality, undermining the efficacy of medical interventions that have been critical to human health for decades. AMR is a natural phenomenon accelerated by the misuse and overuse of antimicrobial agents in humans, animals, and agriculture. When bacteria, for example, are exposed to an antimicrobial drug, those that survive may carry resistance genes, which can be transferred to other bacteria, leading to the spread of resistance. The development of AMR is not limited to bacteria; viruses, fungi, and parasites also adapt and become resistant to antiviral, antifungal, and antiparasitic drugs, respectively. This resistance diminishes the ability to treat common infections and perform routine medical procedures safely, leading to longer hospital stays, higher medical costs, and increased mortality
[2]
Llor C, Bjerrum L. Antimicrobial resistance: risk associated with antibiotic overuse and initiatives to reduce the problem. Ther Adv Drug Saf. 2014 Dec; 5(6): 229-41.
. Addressing AMR is not merely a medical or scientific challenge; it is a critical global health security issue. The World Health Organization (WHO) has identified AMR as one of the top ten global health threats, emphasizing the need for immediate and coordinated action to mitigate its impact. The widespread nature of AMR means that resistant pathogens do not recognize borders, leading to the potential for global pandemics that can overwhelm health systems, disrupt economies, and exacerbate health inequalities. As such, combating AMR requires a comprehensive approach involving healthcare systems, policymakers, researchers, and the global community to implement effective strategies for prevention, detection, and response
[3]
Velazquez-Meza ME, Galarde-López M, Carrillo-Quiróz B, Alpuche-Aranda CM. Antimicrobial resistance: One Health approach. Vet World. 2022 Mar; 15(3): 743-749.
2. The Vicious Impact of Antimicrobial Resistance (AMR) on Global Public Health Security
2.1. Increased Mortality and Morbidity
Antimicrobial resistance (AMR) significantly elevates mortality and morbidity rates, as infections once easily treatable become life-threatening. The inability of existing antibiotics to effectively combat resistant pathogens leads to prolonged illnesses, complications, and higher mortality. According to the World Health Organization (WHO), AMR is responsible for approximately 700,000 deaths annually worldwide, a number projected to rise to 10 million by 2050 if no effective measures are taken
[4]
World Health Organization (WHO). "Antimicrobial Resistance: Global Report on Surveillance." 2014.
[4]
. The increased risk of untreatable infections, especially in vulnerable populations such as the elderly, young children, and those with compromised immune systems, exacerbates the public health crisis.
2.2. Impact on Healthcare Systems
AMR places a significant strain on healthcare systems globally. The increased prevalence of drug-resistant infections results in longer hospital stays, a higher demand for intensive care, and the necessity for more complex and expensive treatment regimens. For instance, patients with resistant infections often require second- or third-line treatments, which are not only costlier but also more toxic and less effective. The Centers for Disease Control and Prevention (CDC) reported that more than 2.8 million antibiotic-resistant infections occur annually in the United States alone, leading to over 35,000 deaths
[5]
Centers for Disease Control and Prevention (CDC). "Antibiotic Resistance Threats in the United States." 2019.
[5]
. This situation leads to an overburdened healthcare infrastructure, with limited resources stretched even thinner, particularly in low- and middle-income countries (LMICs) where healthcare systems are already under-resourced.
2.3. Economic Consequences
The economic impact of AMR is profound, affecting both healthcare systems and the broader economy. The costs associated with prolonged hospital stays, more expensive treatments, and increased use of healthcare resources contribute significantly to the financial burden. The World Bank estimates that AMR could cause a reduction in global gross domestic product (GDP) by 1.1% to 3.8% by 2050, depending on the severity of the resistance spread. Additionally, the loss of productivity due to prolonged illness and premature deaths further exacerbates the economic toll, particularly in LMICs where economic resilience is already limited
[6]
World Bank. "Drug-Resistant Infections: A Threat to Our Economic Future." 2017.
[6]
.
2.4. Threat to Medical Advances
AMR poses a severe threat to the progress achieved in modern medicine. The effectiveness of surgeries, cancer therapies, and treatments for chronic diseases heavily relies on the availability of effective antibiotics to prevent and treat infections. Without effective antimicrobials, routine medical procedures such as organ transplants, chemotherapy, and even childbirth become significantly riskier. A report by the Review on Antimicrobial Resistance highlights that the lack of effective antibiotics could mark the end of modern medicine as we know it, leading to a "post-antibiotic era" where common infections and minor injuries can once again become fatal
[7]
Review on Antimicrobial Resistance. "Tackling Drug-Resistant Infections Globally: Final Report and Recommendations." 2016.
Figure 1. Vicious cycle of AMR spread and expansion in the environment
[5]
Centers for Disease Control and Prevention (CDC). "Antibiotic Resistance Threats in the United States." 2019.
[5]
.
3. The Efficient Role of Healthcare Systems in Combating Antimicrobial Resistance (AMR)
3.1. Strengthening Infection Prevention and Control (IPC)
Robust infection prevention and control (IPC) measures are essential in healthcare settings to reduce the spread of antimicrobial-resistant infections. Hospitals and healthcare facilities are high-risk environments where resistant pathogens can easily proliferate and spread. IPC protocols, such as hand hygiene, use of personal protective equipment (PPE), sterilization of medical instruments, and isolation of infected patients, are critical in minimizing transmission. Studies have shown that effective IPC interventions can reduce the incidence of hospital-acquired infections (HAIs) by up to 30%, significantly decreasing the burden of AMR
[8]
World Health Organization (WHO). (2020). Infection prevention and control. Retrieved from WHO.
[8]
.
3.2. Antibiotic Stewardship Programs
Antibiotic stewardship programs (ASPs) play a pivotal role in ensuring the responsible use of antibiotics within healthcare systems. These programs aim to optimize antibiotic prescribing practices, thereby reducing unnecessary prescriptions and encouraging the use of appropriate antibiotics at the right dose and duration. ASPs have been shown to decrease antibiotic resistance rates and improve patient outcomes by ensuring that antibiotics are only used when truly needed. A systematic review of ASPs across various healthcare settings found that these programs resulted in a 19% reduction in antibiotic consumption and a 27% decrease in resistance rates
[9]
Centers for Disease Control and Prevention (CDC). (2021). Antibiotic Stewardship. Retrieved from CDC.
[9]
. Healthcare systems must integrate ASPs into their operational frameworks to combat AMR effectively.
3.3. Surveillance and Monitoring
Comprehensive surveillance systems are crucial for tracking the spread of resistant infections and evaluating the effectiveness of interventions. Surveillance allows healthcare systems to identify emerging resistance patterns, monitor trends, and respond swiftly to outbreaks. The World Health Organization (WHO) advocates for the Global Antimicrobial Resistance Surveillance System (GLASS) as a model for national surveillance programs
[10]
World Health Organization (WHO). (2018). Global Antimicrobial Resistance Surveillance System (GLASS) report. Retrieved from WHO.
[10]
. Effective surveillance systems require collaboration between laboratories, healthcare providers, and public health agencies to ensure timely data collection and reporting. By identifying hotspots of resistance and guiding targeted interventions, surveillance systems are a cornerstone in the fight against AMR
[11]
Tamma, P. D., & Cosgrove, S. E. (2011). Antimicrobial stewardship programs. Clinical Microbiology Reviews, 24(3), 510-548.
Education and training are fundamental to raising awareness about AMR among healthcare professionals and the general public. Healthcare workers need continuous education on the latest guidelines for infection control, antibiotic prescribing, and resistance management. Additionally, public awareness campaigns can inform communities about the risks of AMR and the importance of adhering to prescribed treatments. Studies have demonstrated that education and training programs can lead to significant improvements in adherence to IPC protocols and a reduction in inappropriate antibiotic use
[12]
Dyar, O. J., et al. (2017). Strategies and challenges of antimicrobial stewardship in resource-limited settings. Journal of Antimicrobial Chemotherapy, 72(11), 2911-2918.
4. The Role of Health Policy and Legislatives in Preventing and AMR
4.1. Global and National Policy Frameworks
Antimicrobial resistance (AMR) demands coordinated efforts at both global and national levels. The World Health Organization (WHO) spearheads global initiatives with its Global Action Plan on AMR, which outlines five strategic objectives: improving awareness and understanding of AMR, strengthening surveillance and research, reducing the incidence of infection, optimizing the use of antimicrobial agents, and ensuring sustainable investment in countering AMR. This global framework encourages countries to develop national action plans tailored to their specific contexts, considering local epidemiological, economic, and social factors. Effective national policies are critical in translating global objectives into actionable steps that address the unique challenges each country faces in combating AMR
[13]
Ogyu A, Chan O, Littmann J, Pang HH, Lining X, Liu P, Matsunaga N, Ohmagari N, Fukuda K, Wernli D. National action to combat AMR: a One-Health approach to assess policy priorities in action plans. BMJ Glob Health. 2020 Jul; 5(7): e002427.
Policy plays a pivotal role in regulating the use of antibiotics, both in human healthcare and agriculture. Over-the-counter sales of antibiotics, common in many countries, contribute significantly to the misuse and overuse of these critical drugs. Effective policies should mandate prescription-only sales of antibiotics, with stringent penalties for non-compliance. In agriculture, where antibiotics are often used for growth promotion in livestock, policies should enforce strict regulations to curb this practice. The European Union's ban on the use of antibiotics as growth promoters in animals, implemented in 2006, is a key example of how policy can mitigate AMR in agriculture
[14]
Laxminarayan, R., Duse, A., Wattal, C., et al. (2013). Antibiotic Resistance—the Need for Global Solutions. The Lancet Infectious Diseases, 13(12), 1057-1098.
[14]
.
4.3. Investment in Research and Development
A robust policy framework is necessary to stimulate research and development (R&D) in the fight against AMR. The development of new antibiotics, vaccines, and alternative therapies is crucial to combatting resistant infections. However, the high cost and low financial return on investment in antibiotic development deter many pharmaceutical companies from engaging in R&D
[15]
Dutescu IA, Hillier SA. Encouraging the Development of New Antibiotics: Are Financial Incentives the Right Way Forward? A Systematic Review and Case Study. Infect Drug Resist. 2021 Feb 5; 14: 415-434.
. Policies that provide financial incentives, such as grants, tax credits, and market exclusivity extensions, can encourage innovation in this field. Additionally, public-private partnerships, supported by policy frameworks, can play a significant role in advancing R&D efforts against AMR
[16]
Renwick, M. J., Brogan, D. M., & Mossialos, E. (2016). A Systematic Review and Critical Assessment of Incentive Strategies for Discovery and Development of Novel Antibiotics. The Journal of Antibiotics, 69(2), 73-88.
[16]
.
4.4. International Collaboration
The global nature of AMR necessitates international collaboration in sharing data, resources, and strategies. Cross-border cooperation enables countries to track the spread of resistant pathogens, share best practices, and align policies to create a unified front against AMR. The Global Antimicrobial Resistance Surveillance System (GLASS), established by the WHO, is a prime example of how international collaboration can enhance global surveillance and inform policy decisions
[17]
Ajulo S, Awosile B. Global antimicrobial resistance and use surveillance system (GLASS 2022): Investigating the relationship between antimicrobial resistance and antimicrobial consumption data across the participating countries. PLoS One. 2024 Feb 5; 19(2): e0297921.
. Policies that facilitate international partnerships, particularly in low- and middle-income countries, are essential in ensuring a comprehensive global response to AMR.
Figure 3. Schematic diagram showing the main steps needed to be implemented to minimize the antimicrobial drug resistance
[14]
Laxminarayan, R., Duse, A., Wattal, C., et al. (2013). Antibiotic Resistance—the Need for Global Solutions. The Lancet Infectious Diseases, 13(12), 1057-1098.
[14]
.
5. Successful Initiatives & Beneficial Outcomes of Antimicrobial Resistance Interventions
5.1. The Netherlands: A Comprehensive Approach to Antibiotic Stewardship
The Netherlands is renowned for its successful implementation of stringent antibiotic stewardship programs, which have significantly reduced antimicrobial resistance rates in the country. The Dutch approach combines prudent antibiotic prescribing practices with robust infection prevention and control measures across healthcare settings, including hospitals, primary care, and livestock farming’s
[18]
Hu XY, Logue M, Robinson N. Antimicrobial resistance is a global problem - a UK perspective. Eur J Integr Med. 2020 Jun; 36: 101136.
5.1.1. Key Interventions related to AMR in Netherlands
1. National Antibiotic Policy: The Dutch government established a comprehensive national antibiotic policy in the 1990s that includes guidelines for antibiotic use, monitoring of antibiotic resistance, and public awareness campaigns
[19]
Köck R, Becker K, Idelevich EA, Jurke A, Glasner C, Hendrix R, Friedrich AW. Prevention and Control of Multidrug-Resistant Bacteria in The Netherlands and Germany-The Impact of Healthcare Structures. Int J Environ Res Public Health. 2020 Mar 30; 17(7): 2337.
2. Surveillance and Monitoring: The Netherlands employs an advanced surveillance system, the Infectious Disease Surveillance Information System-Antibiotic Resistance (ISIS-AR), to track antibiotic resistance patterns and inform policy adjustments.
3. Antibiotic Usage Guidelines: Strict guidelines are in place for prescribing antibiotics, emphasizing the importance of using narrow-spectrum antibiotics whenever possible and limiting the use of broad-spectrum antibiotics.
4. Public Awareness Campaigns: Continuous public awareness campaigns educate citizens about the risks of antibiotic misuse, promoting responsible use of antibiotics among the general population.
5.1.2. Beneficial Outcomes of Antimicrobial Resistance Interventions in Netherlands
As a result of these measures, the Netherlands has one of the lowest rates of antibiotic resistance in Europe. The success of their approach demonstrates the critical role of coordinated national policies, healthcare system engagement, and public education in combating AMR
[20]
Gilham, E. L., Pearce-Smith, N., Carter, V. et al. Assessment of global antimicrobial resistance campaigns conducted to improve public awareness and antimicrobial use behaviours: a rapid systematic review. BMC Public Health 24, 396 (2024).
5.2. Thailand: The National Strategic Plan on AMR (2017-2021)
Thailand has made significant strides in combating AMR through the implementation of its National Strategic Plan on Antimicrobial Resistance (2017-2021). This plan was designed to address the growing threat of AMR through a multi-sectoral approach, incorporating human health, animal health, and environmental health perspectives
[21]
Sumpradit N, Wongkongkathep S, Malathum K, Janejai N, Paveenkittiporn W, Yingyong T, Chuxnum T, Vijitleela A, Boonyarit P, Akaleephan C, Manosuthi W, Thienthong V, Srinha J, Wongsrichai S, Laoprasert T, Athipunyakom P, Kriengchaiyaprug N, Intarukdach K, Numsawad S, Somjetanakul N, Punnin S, Kiatying-Angsulee N. Thailand's national strategic plan on antimicrobial resistance: progress and challenges. Bull World Health Organ. 2021 Sep 1; 99(9): 661-673.
5.2.1. Key Interventions Related to AMR in Thailand
1. Multi-Sectoral Collaboration: Thailand’s strategy emphasizes collaboration between various sectors, including health, agriculture, and environmental agencies, to tackle AMR comprehensively
[22]
Sabbatucci M, Ashiru-Oredope D, Barbier L, Bohin E, Bou-Antoun S, Brown C, Clarici A, Fuentes C, Goto T, Maraglino F, Morin J, Rönnefahrt I, Sanwidi A, Triggs-Hodge C, Vitiello A, Zovi A, Gelormini M, Lo Fo Wong D. Tracking progress on antimicrobial resistance by the quadripartite country self-assessment survey (TrACSS) in G7 countries, 2017-2023: opportunities and gaps. Pharmacol Res. 2024 Jun; 204: 107188.
2. AMR Surveillance: The country has strengthened its surveillance system for monitoring AMR in both humans and animals, enabling the collection of data to guide interventions.
3. Antibiotic Stewardship Programs: Hospitals and healthcare facilities across Thailand have implemented antibiotic stewardship programs to ensure appropriate use of antimicrobials.
4. Regulation and Control: Strict regulations have been introduced to control the use of antibiotics in agriculture, particularly in livestock, where the misuse of antibiotics is a significant driver of resistance.
5.2.2. Beneficial Outcomes of Antimicrobial Resistance Interventions in Netherlands
The implementation of Thailand's National Strategic Plan on AMR has led to a reduction in antibiotic consumption in both human and animal sectors and a noticeable decline in resistance rates for certain pathogens. This success highlights the importance of a comprehensive, multi-sectoral approach in combating AMR at the national level
[23]
Tangcharoensathien V, Sattayawutthipong W, Kanjanapimai S, Kanpravidth W, Brown R, Sommanustweechai A. Antimicrobial resistance: from global agenda to national strategic plan, Thailand. Bull World Health Organ. 2017 Aug 1; 95(8): 599-603.
5.3. United Kingdom: The AMR Review and "Antibiotic Guardians" Campaign
The United Kingdom (UK) has been at the forefront of global efforts to tackle AMR, particularly through the publication of the influential AMR Review (2014-2016), chaired by economist Jim O’Neill. The UK government has also launched the "Antibiotic Guardians" campaign, which encourages individuals and healthcare professionals to commit to using antibiotics responsibly
[24]
Sumpradit N, Wongkongkathep S, Poonpolsup S, Janejai N, Paveenkittiporn W, Boonyarit P, Jaroenpoj S, Kiatying-Angsulee N, Kalpravidh W, Sommanustweechai A, Tangcharoensathien V. New chapter in tackling antimicrobial resistance in Thailand. BMJ. 2017 Sep 5; 358: j3415.
5.3.1. Key Interventions Related to AMR in United Kingdom
1. AMR Review: The AMR Review provided a comprehensive analysis of the global threat of AMR, proposing actionable recommendations to governments worldwide, such as incentivizing the development of new antibiotics and improving global AMR surveillance.
2. Public Health Campaigns: The "Antibiotic Guardians" campaign is a public health initiative that aims to increase awareness of AMR and encourage responsible antibiotic use among healthcare professionals and the public
[24]
Sumpradit N, Wongkongkathep S, Poonpolsup S, Janejai N, Paveenkittiporn W, Boonyarit P, Jaroenpoj S, Kiatying-Angsulee N, Kalpravidh W, Sommanustweechai A, Tangcharoensathien V. New chapter in tackling antimicrobial resistance in Thailand. BMJ. 2017 Sep 5; 358: j3415.
3. Research and Development Incentives: The UK government has introduced incentives for pharmaceutical companies to develop new antibiotics, addressing the gap in the antibiotic development pipeline.
5.3.2. Beneficial Outcomes of Antimicrobial Resistance Interventions in Netherlands
The UK’s efforts have led to increased global awareness of AMR and significant policy changes within the country. The "Antibiotic Guardians" campaign has also contributed to a reduction in unnecessary antibiotic prescriptions in the UK. The UK’s approach underscores the importance of leadership, public engagement, and international collaboration in the fight against AMR
[24]
Sumpradit N, Wongkongkathep S, Poonpolsup S, Janejai N, Paveenkittiporn W, Boonyarit P, Jaroenpoj S, Kiatying-Angsulee N, Kalpravidh W, Sommanustweechai A, Tangcharoensathien V. New chapter in tackling antimicrobial resistance in Thailand. BMJ. 2017 Sep 5; 358: j3415.
Figure 4. Prevention Strategies to Combat Antimicrobial Resistance in Children in Resource-Limited Settings.
6. Challenges and Obstacles in Addressing and Preventing Antimicrobial Resistance (AMR)
The fight against antimicrobial resistance (AMR) is fraught with numerous challenges and barriers, particularly in the context of global public health. These obstacles significantly hinder the implementation of effective AMR strategies and require a coordinated effort from various stakeholders, including governments, healthcare providers, and international organizations. This section will explore the primary challenges and barriers, with a focus on resource limitations, lack of awareness, resistance from stakeholders, and the specific difficulties faced by low- and middle-income countries (LMICs)
One of the most significant challenges in combating AMR is the lack of resources. Many healthcare systems, especially in LMICs, are underfunded and ill-equipped to implement comprehensive AMR strategies. The lack of diagnostic tools, inadequate infrastructure, and insufficient access to essential medicines and vaccines are critical issues that hamper efforts to control the spread of resistant pathogens
[26]
Walsh TR, Gales AC, Laxminarayan R, Dodd PC. Antimicrobial Resistance: Addressing a Global Threat to Humanity. PLoS Med. 2023 Jul 3; 20(7): e1004264.
. Furthermore, the high cost of developing new antimicrobials and the financial burden of implementing robust AMR surveillance systems are often beyond the reach of resource-constrained countries.
6.2. Lack of Awareness and Education
Another major challenge is the widespread lack of awareness and education about AMR among healthcare providers, policymakers, and the general public. Misuse and overuse of antibiotics are rampant due to misinformation, leading to the acceleration of resistance. Healthcare providers may lack adequate training on appropriate prescribing practices, while the public often demands antibiotics for viral infections, further exacerbating the problem. Effective AMR strategies require extensive public education campaigns and professional training programs, which are often lacking, particularly in LMICs
[27]
O'Neill, J. (2016). Tackling drug-resistant infections globally: final report and recommendations. Review on Antimicrobial Resistance.
[27]
.
6.3. Resistance from Stakeholders
Resistance from various stakeholders, including pharmaceutical companies, healthcare providers, and even patients, poses a significant barrier to the implementation of AMR strategies. Pharmaceutical companies may be reluctant to invest in the development of new antibiotics due to the low profitability and the strict regulatory environment. Healthcare providers may resist changes to prescribing practices due to established routines or the pressure to satisfy patient demands. Additionally, patients themselves may resist adhering to prescribed treatment regimens, leading to incomplete courses of antibiotics and increased resistance
[28]
Hollis, A., & Ahmed, Z. (2013). Preserving antibiotics, rationally. New England Journal of Medicine, 369(26), 2474-2476.
[28]
.
6.4. Barriers Encountered by Low and Middle Income Countries in Battling AMR
LMICs face unique challenges in combating AMR due to their limited healthcare infrastructure, inadequate regulatory frameworks, and high burden of infectious diseases. The lack of access to clean water and sanitation, coupled with the over-the-counter availability of antibiotics, contributes to the uncontrolled spread of resistant pathogens. Furthermore, LMICs often lack the capacity to implement and enforce AMR policies, such as antimicrobial stewardship programs and infection prevention and control measures. International support in the form of financial aid, technical assistance, and capacity-building initiatives is crucial for these countries to overcome these barriers
[29]
Mendelson, M., & Matsoso, M. P. (2015). The World Health Organization Global Action Plan for antimicrobial resistance. South African Medical Journal, 105(5), 325-325.
[29]
.
6.5. The Need for International Support in Preventing AMR
International cooperation and support are essential to addressing the global threat of AMR, particularly for LMICs. This includes the provision of funding for research and development, capacity building for healthcare systems, and the establishment of global surveillance networks. Multilateral organizations such as the World Health Organization (WHO) and the United Nations (UN) play a critical role in coordinating global efforts and mobilizing resources. Collaborative initiatives, such as the Global Action Plan on Antimicrobial Resistance, provide a framework for international cooperation, but more needs to be done to ensure that LMICs are not left behind in the fight against AMR
[30]
Chen S, Zhang J, Wu Y. National Action Plan in Antimicrobial Resistance Using Framework Analysis for China. China CDC Wkly. 2023 Jun 2; 5(22): 492-498.
The escalating threat of antimicrobial resistance (AMR) poses a grave danger to global public health security, challenging the efficacy of existing medical interventions and complicating the management of infectious diseases. The vicious cycle of AMR, driven by the misuse and overuse of antibiotics, coupled with inadequate infection control measures, threatens to reverse decades of medical progress. The growing prevalence of resistant pathogens underscores the urgent need for a robust and coordinated global response. Healthcare systems and policy frameworks play a pivotal role in combating AMR. Effective strategies must include strengthening global surveillance systems, promoting the judicious use of antimicrobials, and investing in research and development of new antibiotics. Additionally, enhancing public awareness and education about the risks of AMR is crucial in fostering responsible behavior among healthcare providers and the general population. Global collaboration is essential to address the AMR crisis. Policymakers must prioritize AMR as a critical component of national and international health agendas, integrating it into broader public health policies and initiatives. By adopting a multi-faceted approach that includes prevention, control, and innovation, we can mitigate the impact of AMR and protect the efficacy of antimicrobial agents for future generations.
Conflicts of Interest
The authors declare no conflicts of interest.
References
[1]
Antimicrobial Resistance Collaborators. (2022). Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. The Lancet; 399(10325): P629-655.
Llor C, Bjerrum L. Antimicrobial resistance: risk associated with antibiotic overuse and initiatives to reduce the problem. Ther Adv Drug Saf. 2014 Dec; 5(6): 229-41.
Velazquez-Meza ME, Galarde-López M, Carrillo-Quiróz B, Alpuche-Aranda CM. Antimicrobial resistance: One Health approach. Vet World. 2022 Mar; 15(3): 743-749.
Dyar, O. J., et al. (2017). Strategies and challenges of antimicrobial stewardship in resource-limited settings. Journal of Antimicrobial Chemotherapy, 72(11), 2911-2918.
Ogyu A, Chan O, Littmann J, Pang HH, Lining X, Liu P, Matsunaga N, Ohmagari N, Fukuda K, Wernli D. National action to combat AMR: a One-Health approach to assess policy priorities in action plans. BMJ Glob Health. 2020 Jul; 5(7): e002427.
Laxminarayan, R., Duse, A., Wattal, C., et al. (2013). Antibiotic Resistance—the Need for Global Solutions. The Lancet Infectious Diseases, 13(12), 1057-1098.
[15]
Dutescu IA, Hillier SA. Encouraging the Development of New Antibiotics: Are Financial Incentives the Right Way Forward? A Systematic Review and Case Study. Infect Drug Resist. 2021 Feb 5; 14: 415-434.
Renwick, M. J., Brogan, D. M., & Mossialos, E. (2016). A Systematic Review and Critical Assessment of Incentive Strategies for Discovery and Development of Novel Antibiotics. The Journal of Antibiotics, 69(2), 73-88.
[17]
Ajulo S, Awosile B. Global antimicrobial resistance and use surveillance system (GLASS 2022): Investigating the relationship between antimicrobial resistance and antimicrobial consumption data across the participating countries. PLoS One. 2024 Feb 5; 19(2): e0297921.
Köck R, Becker K, Idelevich EA, Jurke A, Glasner C, Hendrix R, Friedrich AW. Prevention and Control of Multidrug-Resistant Bacteria in The Netherlands and Germany-The Impact of Healthcare Structures. Int J Environ Res Public Health. 2020 Mar 30; 17(7): 2337.
Gilham, E. L., Pearce-Smith, N., Carter, V. et al. Assessment of global antimicrobial resistance campaigns conducted to improve public awareness and antimicrobial use behaviours: a rapid systematic review. BMC Public Health 24, 396 (2024).
Sabbatucci M, Ashiru-Oredope D, Barbier L, Bohin E, Bou-Antoun S, Brown C, Clarici A, Fuentes C, Goto T, Maraglino F, Morin J, Rönnefahrt I, Sanwidi A, Triggs-Hodge C, Vitiello A, Zovi A, Gelormini M, Lo Fo Wong D. Tracking progress on antimicrobial resistance by the quadripartite country self-assessment survey (TrACSS) in G7 countries, 2017-2023: opportunities and gaps. Pharmacol Res. 2024 Jun; 204: 107188.
Tangcharoensathien V, Sattayawutthipong W, Kanjanapimai S, Kanpravidth W, Brown R, Sommanustweechai A. Antimicrobial resistance: from global agenda to national strategic plan, Thailand. Bull World Health Organ. 2017 Aug 1; 95(8): 599-603.
Sumpradit N, Wongkongkathep S, Poonpolsup S, Janejai N, Paveenkittiporn W, Boonyarit P, Jaroenpoj S, Kiatying-Angsulee N, Kalpravidh W, Sommanustweechai A, Tangcharoensathien V. New chapter in tackling antimicrobial resistance in Thailand. BMJ. 2017 Sep 5; 358: j3415.
O'Neill, J. (2016). Tackling drug-resistant infections globally: final report and recommendations. Review on Antimicrobial Resistance.
[28]
Hollis, A., & Ahmed, Z. (2013). Preserving antibiotics, rationally. New England Journal of Medicine, 369(26), 2474-2476.
[29]
Mendelson, M., & Matsoso, M. P. (2015). The World Health Organization Global Action Plan for antimicrobial resistance. South African Medical Journal, 105(5), 325-325.
[30]
Chen S, Zhang J, Wu Y. National Action Plan in Antimicrobial Resistance Using Framework Analysis for China. China CDC Wkly. 2023 Jun 2; 5(22): 492-498.
Sultana, M., Perves, N., Uddin, N., Chowdhury, M. K., Amin, N. (2024). The Vicious Impact of Antimicrobial Resistance on Global Public Health Security and the Role of Healthcare Systems and Policy in Combating AMR. World Journal of Public Health, 9(3), 286-294. https://doi.org/10.11648/j.wjph.20240903.17
Sultana, M.; Perves, N.; Uddin, N.; Chowdhury, M. K.; Amin, N. The Vicious Impact of Antimicrobial Resistance on Global Public Health Security and the Role of Healthcare Systems and Policy in Combating AMR. World J. Public Health2024, 9(3), 286-294. doi: 10.11648/j.wjph.20240903.17
Sultana M, Perves N, Uddin N, Chowdhury MK, Amin N. The Vicious Impact of Antimicrobial Resistance on Global Public Health Security and the Role of Healthcare Systems and Policy in Combating AMR. World J Public Health. 2024;9(3):286-294. doi: 10.11648/j.wjph.20240903.17
@article{10.11648/j.wjph.20240903.17,
author = {Maleka Sultana and Noman Perves and Nasir Uddin and Mahbub-E-Elahi Khan Chowdhury and Nurul Amin},
title = {The Vicious Impact of Antimicrobial Resistance on Global Public Health Security and the Role of Healthcare Systems and Policy in Combating AMR
},
journal = {World Journal of Public Health},
volume = {9},
number = {3},
pages = {286-294},
doi = {10.11648/j.wjph.20240903.17},
url = {https://doi.org/10.11648/j.wjph.20240903.17},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.wjph.20240903.17},
abstract = {Antimicrobial resistance (AMR) has emerged as one of the most formidable challenges to public health security worldwide, threatening the effectiveness of essential medical treatments and the management of infectious diseases. The relentless spread of resistant pathogens compromises the effectiveness of life-saving treatments, leading to longer hospital stays, higher medical costs, and increased mortality. This article delves into the profound and multifaceted impact of AMR, illustrating how it undermines the ability to treat common infections, perform routine surgeries, and manage chronic conditions. The vicious cycle of AMR not only exacerbates the burden on healthcare systems but also threatens to reverse decades of medical progress, potentially plunging the world into a post-antibiotic era where minor infections could once again be fatal. The article further explores the integral role of healthcare systems and policy frameworks in addressing this burgeoning crisis. It discusses how the lack of coordinated global strategies and inconsistent policy implementation have allowed AMR to flourish, emphasizing the need for robust healthcare infrastructures that prioritize the prevention and control of resistance. Critical measures such as enhancing global surveillance systems, promoting antimicrobial stewardship, and fostering innovation in new drug development are identified as pivotal in the fight against AMR. Moreover, the article highlights the importance of policy-driven interventions, including the enforcement of regulations on antibiotic use, investment in public health education, and the integration of AMR action plans into national health policies. By examining successful case studies and identifying gaps in current approaches, the article provides a comprehensive analysis of how healthcare systems and policy can be leveraged to combat AMR effectively. The discussion culminates in a call for a unified global response, underscoring that combating AMR requires not only technological advancements but also sustained political commitment and international collaboration to secure a safer, healthier future for all.
},
year = {2024}
}
TY - JOUR
T1 - The Vicious Impact of Antimicrobial Resistance on Global Public Health Security and the Role of Healthcare Systems and Policy in Combating AMR
AU - Maleka Sultana
AU - Noman Perves
AU - Nasir Uddin
AU - Mahbub-E-Elahi Khan Chowdhury
AU - Nurul Amin
Y1 - 2024/09/20
PY - 2024
N1 - https://doi.org/10.11648/j.wjph.20240903.17
DO - 10.11648/j.wjph.20240903.17
T2 - World Journal of Public Health
JF - World Journal of Public Health
JO - World Journal of Public Health
SP - 286
EP - 294
PB - Science Publishing Group
SN - 2637-6059
UR - https://doi.org/10.11648/j.wjph.20240903.17
AB - Antimicrobial resistance (AMR) has emerged as one of the most formidable challenges to public health security worldwide, threatening the effectiveness of essential medical treatments and the management of infectious diseases. The relentless spread of resistant pathogens compromises the effectiveness of life-saving treatments, leading to longer hospital stays, higher medical costs, and increased mortality. This article delves into the profound and multifaceted impact of AMR, illustrating how it undermines the ability to treat common infections, perform routine surgeries, and manage chronic conditions. The vicious cycle of AMR not only exacerbates the burden on healthcare systems but also threatens to reverse decades of medical progress, potentially plunging the world into a post-antibiotic era where minor infections could once again be fatal. The article further explores the integral role of healthcare systems and policy frameworks in addressing this burgeoning crisis. It discusses how the lack of coordinated global strategies and inconsistent policy implementation have allowed AMR to flourish, emphasizing the need for robust healthcare infrastructures that prioritize the prevention and control of resistance. Critical measures such as enhancing global surveillance systems, promoting antimicrobial stewardship, and fostering innovation in new drug development are identified as pivotal in the fight against AMR. Moreover, the article highlights the importance of policy-driven interventions, including the enforcement of regulations on antibiotic use, investment in public health education, and the integration of AMR action plans into national health policies. By examining successful case studies and identifying gaps in current approaches, the article provides a comprehensive analysis of how healthcare systems and policy can be leveraged to combat AMR effectively. The discussion culminates in a call for a unified global response, underscoring that combating AMR requires not only technological advancements but also sustained political commitment and international collaboration to secure a safer, healthier future for all.
VL - 9
IS - 3
ER -
Department of Pharmacy, University of Karachi, Karachi, Pakistan; Patient Access and Key Account Management, Novartis Bangladesh Limited, Dhaka, Bangladesh
Sultana, M., Perves, N., Uddin, N., Chowdhury, M. K., Amin, N. (2024). The Vicious Impact of Antimicrobial Resistance on Global Public Health Security and the Role of Healthcare Systems and Policy in Combating AMR. World Journal of Public Health, 9(3), 286-294. https://doi.org/10.11648/j.wjph.20240903.17
Sultana, M.; Perves, N.; Uddin, N.; Chowdhury, M. K.; Amin, N. The Vicious Impact of Antimicrobial Resistance on Global Public Health Security and the Role of Healthcare Systems and Policy in Combating AMR. World J. Public Health2024, 9(3), 286-294. doi: 10.11648/j.wjph.20240903.17
Sultana M, Perves N, Uddin N, Chowdhury MK, Amin N. The Vicious Impact of Antimicrobial Resistance on Global Public Health Security and the Role of Healthcare Systems and Policy in Combating AMR. World J Public Health. 2024;9(3):286-294. doi: 10.11648/j.wjph.20240903.17
@article{10.11648/j.wjph.20240903.17,
author = {Maleka Sultana and Noman Perves and Nasir Uddin and Mahbub-E-Elahi Khan Chowdhury and Nurul Amin},
title = {The Vicious Impact of Antimicrobial Resistance on Global Public Health Security and the Role of Healthcare Systems and Policy in Combating AMR
},
journal = {World Journal of Public Health},
volume = {9},
number = {3},
pages = {286-294},
doi = {10.11648/j.wjph.20240903.17},
url = {https://doi.org/10.11648/j.wjph.20240903.17},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.wjph.20240903.17},
abstract = {Antimicrobial resistance (AMR) has emerged as one of the most formidable challenges to public health security worldwide, threatening the effectiveness of essential medical treatments and the management of infectious diseases. The relentless spread of resistant pathogens compromises the effectiveness of life-saving treatments, leading to longer hospital stays, higher medical costs, and increased mortality. This article delves into the profound and multifaceted impact of AMR, illustrating how it undermines the ability to treat common infections, perform routine surgeries, and manage chronic conditions. The vicious cycle of AMR not only exacerbates the burden on healthcare systems but also threatens to reverse decades of medical progress, potentially plunging the world into a post-antibiotic era where minor infections could once again be fatal. The article further explores the integral role of healthcare systems and policy frameworks in addressing this burgeoning crisis. It discusses how the lack of coordinated global strategies and inconsistent policy implementation have allowed AMR to flourish, emphasizing the need for robust healthcare infrastructures that prioritize the prevention and control of resistance. Critical measures such as enhancing global surveillance systems, promoting antimicrobial stewardship, and fostering innovation in new drug development are identified as pivotal in the fight against AMR. Moreover, the article highlights the importance of policy-driven interventions, including the enforcement of regulations on antibiotic use, investment in public health education, and the integration of AMR action plans into national health policies. By examining successful case studies and identifying gaps in current approaches, the article provides a comprehensive analysis of how healthcare systems and policy can be leveraged to combat AMR effectively. The discussion culminates in a call for a unified global response, underscoring that combating AMR requires not only technological advancements but also sustained political commitment and international collaboration to secure a safer, healthier future for all.
},
year = {2024}
}
TY - JOUR
T1 - The Vicious Impact of Antimicrobial Resistance on Global Public Health Security and the Role of Healthcare Systems and Policy in Combating AMR
AU - Maleka Sultana
AU - Noman Perves
AU - Nasir Uddin
AU - Mahbub-E-Elahi Khan Chowdhury
AU - Nurul Amin
Y1 - 2024/09/20
PY - 2024
N1 - https://doi.org/10.11648/j.wjph.20240903.17
DO - 10.11648/j.wjph.20240903.17
T2 - World Journal of Public Health
JF - World Journal of Public Health
JO - World Journal of Public Health
SP - 286
EP - 294
PB - Science Publishing Group
SN - 2637-6059
UR - https://doi.org/10.11648/j.wjph.20240903.17
AB - Antimicrobial resistance (AMR) has emerged as one of the most formidable challenges to public health security worldwide, threatening the effectiveness of essential medical treatments and the management of infectious diseases. The relentless spread of resistant pathogens compromises the effectiveness of life-saving treatments, leading to longer hospital stays, higher medical costs, and increased mortality. This article delves into the profound and multifaceted impact of AMR, illustrating how it undermines the ability to treat common infections, perform routine surgeries, and manage chronic conditions. The vicious cycle of AMR not only exacerbates the burden on healthcare systems but also threatens to reverse decades of medical progress, potentially plunging the world into a post-antibiotic era where minor infections could once again be fatal. The article further explores the integral role of healthcare systems and policy frameworks in addressing this burgeoning crisis. It discusses how the lack of coordinated global strategies and inconsistent policy implementation have allowed AMR to flourish, emphasizing the need for robust healthcare infrastructures that prioritize the prevention and control of resistance. Critical measures such as enhancing global surveillance systems, promoting antimicrobial stewardship, and fostering innovation in new drug development are identified as pivotal in the fight against AMR. Moreover, the article highlights the importance of policy-driven interventions, including the enforcement of regulations on antibiotic use, investment in public health education, and the integration of AMR action plans into national health policies. By examining successful case studies and identifying gaps in current approaches, the article provides a comprehensive analysis of how healthcare systems and policy can be leveraged to combat AMR effectively. The discussion culminates in a call for a unified global response, underscoring that combating AMR requires not only technological advancements but also sustained political commitment and international collaboration to secure a safer, healthier future for all.
VL - 9
IS - 3
ER -
Share This Article
Twitter
Linked In
Facebook
Copy
Download
