The World Health Organization (WHO) has completed the first global assessment of national strategies to counter the rise of antimicrobial resistance (AMR). Only a quarter to countries had plans in place to limit the use of antimicrobials, leaving "major gaps" in the struggle against AMR in every region of the world.
The rise of AMR is tied to the overuse and misuse of antimicrobial medicines such as antibiotics. When microbes targeted by antimicrobial medicines are not eliminated, certain traits that caused them to be resistant to a treatment are replicated.
When drug-resistant strains of a disease-causing microbe are found, different antimicrobials must be substituted to effectively treat the infection. However, because there has been a significant decline in the number of new antimicrobial products in the past several decades, healthcare providers are left with few options to treat highly resistant bacteria such as Neisseria gonorrhoeae.
In 2014, WHO completed its first global report on AMR. The opening lines of the report were alarming:
"AMR … threatens the achievements of modern medicine. A post-antibiotic era—in which common infections and minor injuries can kill—far from being an apocalyptic fantasy, is instead a very real possibility for the 21st century."
In the report, WHO found high rates of AMR in a number of common infections in every region of the world. Additionally, WHO observed "significant gaps in surveillance," that made it difficult to get an accurate understanding of the extent of the situation.
The new assessment, Worldwide country situation analysis: Response to antimicrobial resistance, which was conducted in 2013 and 2014, fielded responses from 133 countries on their efforts to curb the effects of AMR.
The report highlights several challenges that must be overcome in the fight against AMR, including strengthening surveillance mechanisms, raising public awareness, developing treatment guidelines for antimicrobial medicines and implementing preventative measures to reduce the number of infections that occur.
According to WHO, "comprehensive national plans … are regarded as one of the main ways to fight AMR globally." Unfortunately, only a quarter of countries reported having such initiatives.
While WHO received responses from countries in all six WHO regions, only 17% of countries in the African region and 62% of countries in the Eastern Mediterranean Region completed the assessment. Of the countries reporting, the Southeast Asia Region and European Region were the most likely to have a national action plan to combat AMR, at 45% and 43%, respectively. Only one region, South-East Asia, had published progress reports for all countries reporting.
Similarly, countries in South-East Asia were more likely to conduct surveillance for AMR than other regions, with 82-100% of countries screening for AMR in bacteria, tuberculosis, malaria, influenza and HIV.
Africa and the Eastern Mediterranean consistently came behind the other regions, reporting lower rates of national action plans, surveillance measures and public awareness.
Worldwide country situation analysis: Response to antimicrobial resistance