Antimicrobial resistance (AMR) is a significant global health concern. It refers to the ability of microorganisms such as bacteria, viruses, and parasites to resist the effects of antimicrobial drugs, making infections more difficult to treat and increasing the risk of severe illness or death. According to new research, governments all over the world must do more to combat the growing threat of drug-resistant infections.
Over 100 countries have developed national action plans to combat the threat of antimicrobial resistance (AMR), which occurs when bacteria, viruses, fungi, and parasites stop responding to medicines designed to treat them. The plans focus on developing policies to combat AMR and tools to implement those policies, but they fail to account for monitoring and evaluation.
The new research, carried out by experts at the universities of Leeds, Edinburgh, and Hamburg, is the first large-scale analysis of these plans. They were designed after encouragement from the World Health Organisation, which has declared AMR one of the top 10 public health threats facing humanity.
Our analysis showed that countries were highly focused on designing AMR policies, and thinking about what tools would be required to implement those, but they generally did not consider how they would monitor and evaluate the impact of those efforts.
Jay Patel
Lead author Jay Patel, undergraduate dental student in the University of Leeds’ School of Dentistry, said: “Our analysis showed that countries were highly focused on designing AMR policies, and thinking about what tools would be required to implement those, but they generally did not consider how they would monitor and evaluate the impact of those efforts.”
“This suggests that the international response may be insufficient to deal with the magnitude and severity of AMR.” This is especially concerning in low and middle-income countries, where action plan activities frequently lack long-term funding, instead relying on funds from foreign donors and philanthropies. The evidence also suggests that simply developing a national action plan does not necessarily indicate that a country is better prepared to respond to the threat of AMR.”
“Our research shows that the global response to AMR, as well as preparedness for the predicted AMR challenges, require improvement in all parts of the world.”
According to the research team, governments around the world must strengthen their AMR responses.
What is antimicrobial resistance?
AMR refers to changes in microbes, particularly bacteria, that cause antibiotics to become less effective in treating infections. In the twenty-first century, AMR has emerged as a defining challenge for global public health. AMR was a factor in 4.95 million deaths worldwide in 2019 alone, accounting for more than half of all deaths caused by bacterial infections.
Without action, AMR could render many common antibiotics ineffective, claiming the lives of tens of millions of people each year. The World Health Organization encouraged member countries to develop national action plans outlining how they would combat AMR in 2017. More than 100 countries have developed action plans, with several of them being implemented; however, there has been no global analysis of the content of these plans.
Published in The Lancet Infectious Diseases, this new research is the first to comprehensively assess international AMR efforts and national action plans and generate comparable quantitative results across countries and regions.
The 114 action plans, which were created in 2020-21, were evaluated against 54 elements, such as education, stewardship, and accountability, and each awarded a score out of 100. A mean score out of 100 for each country’s plan was then taken from these results.
The findings
The study found that across all plans, there was a greater focus on policy design and implementation tools, but efforts to monitor and evaluate activities are generally poorly-considered. Of all areas evaluated, accountability and feedback mechanisms were the joint-lowest scoring, followed by education.
Many countries lacked adequate training and professional education in the human health, veterinary, and agricultural sectors, and several lacked a long-term workforce strategy to implement antimicrobial stewardship policies.
Countries performed well in terms of participation, demonstrating a shared understanding that AMR can only be successfully addressed through collaboration across multiple sectors, including human, animal, and environmental health. Infection prevention and control were frequently identified as critical goals.
