Antimicrobial agents such as antibiotics, antivirals, antifungals, and antiparasitics are used to resist a wide range of infections. Common diseases such as malaria, tuberculosis (TB), sexually transmitted infections, food poisoning, urinary tract infections (UTIs), HIV/AIDS and blood infections are treated with antimicrobial drugs.³

AMR occurs when common antimicrobial drugs do not respond effectively to microbial infections. This condition may result from inappropriate use of antimicrobial drugs, poor infection prevention measures, and insufficient global infection surveillance. In addition, the lack of development of new antimicrobial drugs could also contribute to AMR.⁴

In many developing countries, antibiotics are sold free without a prescription.⁵ Overuse of antibiotics in animals also causes AMR.⁶ In addition, the lack of effective diagnostics in many low- to middle-income countries drives the misuse of antimicrobials that can trigger the growth of superbugs.

An increasing loss of drug efficacy due to AMR has been documented in both developed and developing countries. A continuation of this trend could lead to a condition where the microbial infection will have “no treatment and no vaccine”.

AMR is a global public health concern because it threatens to diminish the achievements of medicine and healthcare delivery. It is important to address AMR immediately because it could compromise the outcome of surgical procedures such as hip and knee replacements, caesarean sections, and heart surgery by causing incision site infections.⁷

The lack of effective antimicrobial drugs could also make routine surgical procedures more dangerous to perform and increase mortality rates. AMR increases an individual’s suffering for longer as infections become more difficult to treat. This can lead to prolonged hospitalization.⁵

Several strategies have been formulated to prevent present and future ADR. Some of the key strategies are discussed below:

Training of health professionals

Competent health workers could play a vital role in reducing AMR.⁸ However, a large proportion of healthcare workers lack adequate training and education in AMR prevention, which hinders their ability to mitigate the spread of AMR. Therefore, developing global standards in education and training for healthcare workers could be an important step in preventing AMR.

Increasing awareness of the impact of ADR among healthcare providers could be an important first step in preventing this condition. Providing healthcare workers with educational materials about AMR through digital learning technologies can strengthen their competence.⁹ This could promote behavioral changes that may contribute to more reasonable use of antimicrobials. Recently, WHO has also published guidelines to help educate and train healthcare workers about AMR.

Communication strategies

Raising public awareness through clear and unambiguous messages on AMR is a useful strategy that involves all stakeholders. Communication specialists need to produce three to four key messages relevant to the country context instead of sending a large volume of information.¹⁰

Health officials and social workers need to target a smaller target group such as school and college students to raise awareness in the short and medium term. An increase in awareness is not guaranteed to lead to short- or medium-term behavioral changes among stakeholders.

Global policies

Inappropriate use of antimicrobial drugs has also been attributed to a lack of robust policies on their correct use and poor monitoring of the drug supply chain at the national and subnational levels.¹¹ Health ministries or departments should be involved in spreading awareness about AMR.

UN agencies such as UNICEF and UNESCO should assist WHO, the Food and Agriculture Organization (FAO) and the World Organization for Animal Health (WOAH) in designing AMR awareness messages on the international stage.¹²

Children are central to AMR, prompting clinicians to develop national prescribing guidelines to prevent variation in prescribing practice in this population. Currently, more than 40 countries follow local guidelines that provide children with optimal doses of antibiotics for their age, weight and condition.

Scientific research

Scientists around the world have focused on repurposing drugs and developing new antibiotics. Non-profit global partnerships such as CARB-X fund scientific research to develop new treatments, particularly for use in low- and middle-income countries.¹³ For example, CARB-X awarded £2 million to the Jenner Institute at Oxford University to develop a new vaccine to prevent multi-drug resistance. Neisseria gonorrhoeae.

Advanced genome sequencing facilities have enabled scientists to detect new variants promptly. In addition, platforms such as the Pew Foundation’s Shared Platform for Antibiotic Research and Knowledge (SPARK) facilitate the sharing of information and data on AMR, which has greatly helped researchers engage in these studies. It also promotes real-time collaboration between academia, physicians, industry and governments, which will significantly help prevent the emergence and spread of resistant microbes.

Scientists have also observed that bodies of water act as a primary vector of AMR transmission, as large amounts of antibiotic manufacturing waste are disposed of here. In this context, Australian scientists detected Enterobacteriaceae, a type of resistant bacteria in green sea turtles on the Great Barrier Reef.

Amala’s story: how to prevent antimicrobial resistancePlay