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

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

In many developing countries, antibiotics are sold freely over the counter without the need for a prescription.⁵ Overuse of antibiotics in livestock also causes AMR.⁶ In addition, the lack of effective diagnostics in many low- to middle-income countries induces the misuse of antimicrobials that can trigger the rise of superbugs.

In both developed and developing countries, an increasing loss of drug efficacy due to AMR has been documented. A continuation of this trend could lead to a state where the microbial infection will have “no cure and no vaccine.”

AMR is a global public health problem because it threatens to reduce the outcomes of medicine and healthcare. It is important to address AMR immediately because it can compromise the outcome of surgical procedures, such as hip and knee replacements, caesarean sections and heart surgery, by causing incisional infections.⁷

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

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

Education of healthcare personnel

Competent healthcare workers can play a crucial role in curbing AMR.⁸ However, a large proportion of healthcare workers lack proper training and education on AMR prevention, which hinders their ability to mitigate the spread of AMR. Therefore, the development of global standards for the education and training of healthcare professionals may be an important step in preventing AMR.

Raising awareness of the effects of AMR among healthcare providers may be the important first step in preventing this condition. Providing healthcare professionals with educational materials about AMR via digital learning technology can strengthen their skills.⁹ This could promote behavioral changes that could contribute to a more reasonable use of antimicrobials. Recently, WHO also published guidelines to help educate and train healthcare professionals about AMR.

Communication strategies

Raising public awareness through clear and unambiguous messages about AMR is a useful strategy that engages all stakeholders. Communication specialists must produce three to four key messages that are relevant to the country environment rather than sending a large amount 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. Increased awareness is not guaranteed to lead to behavioral changes in the short or medium term among stakeholders.

Global politics

The inappropriate use of antimicrobial drugs has also been attributed to the lack of robust guidelines for proper use and poor monitoring of the drug supply chain at national and subnational levels.¹¹ Health ministries or departments should engage 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 practices in this population. Currently, more than 40 countries follow local guidelines that ensure children receive optimal antibiotic doses for their age, weight and condition.

Scientific research

Researchers worldwide have focused on repurposing drugs and developing new antibiotics. Global non-profit 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 the University of Oxford to develop a new vaccine to prevent multi-drug resistant Neisseria gonorrhoeae.

The advanced genome sequencing facilities have enabled researchers to quickly discover new variants. In addition, platforms such as the Pew Foundation’s Shared Platform for Antibiotic Research and Knowledge (SPARK) facilitate the sharing of insights and data on AMR, which has greatly helped researchers engage in these studies. It also promotes real-time collaboration between academia, clinicians, industry and governments, which will significantly contribute to preventing the emergence and spread of resistant microbes.

Researchers have also observed that water bodies act as a primary vector for AMR transmission as large amounts of waste from antibiotic manufacturing are dumped here. In this context, Australian researchers discovered Enterobacteriales, a type of resistant bacteria, in green sea turtles on the Great Barrier Reef.

Amala’s story: how to prevent antimicrobial resistancePlay