Recent projections suggest that 39 million deaths between 2025 and 2050 will be directly attributable to AMR – equivalent to three deaths a minute. The world’s poorest countries will be the most affected. Key drivers of AMR include extensive use of antimicrobials, spread of infections because of water, sanitation and hygiene (WASH) challenges and shortcomings in infection prevention and control, environment contamination with antimicrobials, and extensive antibiotic use in the animal and agricultural sectors.
Global, national and regional responses
The WHO Global AMR Action Plan was published in 2015 and countries have subsequently developed national action plans for AMR. By 2023, 83% of countries in the African Region had developed national action plans. However, only 23% had costed their strategies and were monitoring their plans, indicating that implementation is currently lagging. Obstacles to implementation include limited financing, challenges with intersectoral coordination, and awareness of AMR in non-medical sectors.
Several regional initiatives have been organised in recent years, including the African Union Task Force on AMR, the African Union Framework for AMR Control 2020–2025, and the establishment of the African Union’s Interagency Group on One Health.
Lack of prioritisation
Dr Chanda also highlighted other major challenges, included limited microbiological surveillance, extensive antimicrobial use in the animal sector, and a lack of new antibiotic development. Globally, AMR receives much less funding than infectious diseases such as TB or malaria. This may be a false economy, he suggested, as the return of investment for AMR may be as high as US$7.2–13.1bn for each US$1 invested.
Given the difficulty in mobilizing resources specifically to address AMR, Dr Chanda concluded that there was a need to go “back to basics”. Investing in the building blocks of health systems and public health would help to reduce the risk of infectious disease and improve care, reducing pressures driving the development of AMR, prevent its spread, and reduce the impact of drug-resistant infections.