Global Efforts to Combat Antimicrobial Resistance Show Progress, But Challenges Remain
A recent study published in Nature reveals a complex picture of global efforts to combat antimicrobial resistance (AMR), indicating improvements in governance but highlighting persistent gaps in implementation and monitoring, particularly within the animal and environmental sectors. The research, utilizing a multidimensional One Health governance index, assessed 193 countries between 2017 and 2022, analyzing 269 policy documents and integrating data from surveys and surveillance systems.
The study found that global governance scores improved from 30.7 to 44.5/100 during the study period. However, the impact of these policies on actual AMR outcomes appears delayed, with a significant increase in AMR prevalence scores observed only five years after national action plan (NAP) adoption. This suggests that translating policy into tangible results requires sustained effort and a long-term perspective.
Key factors associated with improved AMR outcomes included multisector engagement in early-adopting countries and the presence of antimicrobial use surveillance systems. Specifically, early-adopting countries with robust multisector engagement saw improvements (β = 0.05, 95% confidence interval (CI) 0.02–0.08, P < 0.01), as did those with antimicrobial use surveillance systems (β = 0.05, 95% CI 0.03–0.07, P < 0.01).
The research underscores the urgent need for sustained financing and integrated One Health surveillance, with a stronger focus on environmental and agricultural engagement, as the 2026 Global Action Plan update approaches. AMR is a significant threat to global health, responsible for an estimated 4.71 million deaths worldwide in 2021, and without effective interventions, annual mortality attributable to AMR is predicted to rise to 8.22 million by 2050.
Data for the study was collected through analysis of national AMR policy documents, the Tracking AMR Country Self-Assessment Survey (TrACSS), and data from organizations including UNICEF, the Global AMR R&D Hub, and the GLASS database. The study period (2017-2022) was determined by the availability of TrACSS survey data.
Researchers utilized a longitudinal, country-level design, combining AMR prevalence, antimicrobial use, and AMR-related mortality data from sources including the Global Burden of Disease study and WHO Global TB Reports. Missing data were addressed using country-specific imputation strategies to preserve temporal structure and cross-country heterogeneity.