Antimicrobial resistance is a phenomenon where the bacteria, viruses, fungi and parasites change overtime and does not responds to the medicines. This makes it difficult to treat the disease and result in risk of disease spread, severe illness and death. As a result of drug resistance, antibiotics and other antimicrobial medicines become ineffective and infections become increasingly difficult or impossible to treat. The emergence and spread of drug-resistant pathogens that have acquired new resistance mechanisms, leading to antimicrobial resistance, continues to threaten our ability to treat common infections.
Especially alarming is the rapid spread worldwide of multi- and pan-resistant bacteria (“superbugs”) that cause infections that cannot be treated with current antimicrobial medicines such as antibiotics. The clinical pipeline of new antimicrobials is dry.
In 2019 WHO identified 32 antibiotics in clinical development that address the WHO list of priority pathogens, of which only six were classified as innovative.
In addition, lack of available quality antimicrobials is still a major concern. There are currently shortages of antibiotics across countries in all levels of development and especially within the health systems.
· Current Landscape of the Antimicrobial Resistance
According to World Health Organization (WHO), in the year 2019 alone, it was estimated that AMR was directly linked to approximately 1.27 million fatalities worldwide. This alarming statistic underscores the urgent need for comprehensive strategies to combat the rise of resistant strains and to safeguard the efficacy of existing antimicrobial agents.
Antimicrobial drugs are the cornerstones of modern medicine. The emergence and spread of drug-resistant microorganisms compromise our ability to treat everyday diseases and perform lifesaving procedures including organ transplantation, hip replacements, chemotherapy for cancer, and cesarean sections.
A recent report of the 2022 Global Antimicrobial Resistance and Use Surveillance System (GLASS) finds alarming resistance levels among common bacterial pathogens. E. Coli and methicillin-resistant Staphylococcus aureus had median reported rates of 42% and 35% across 76 countries, seriously concerning. Already in 2020, the one out of five E. coli urinary tract infection cases presents decreased susceptibility to common antibiotics: ampicillin, co-trimoxazole, and fluoroquinolones.
Accordingly, the ease of treatment for common infections diminishes.
· Coordinated global action to address AMR
One Health Approach: The One Health approach addresses AMR by combining actions across the human health, food production, animal, and environmental sectors. This approach emphasizes that human, animal, and ecosystem health are connected to sustainable outcomes. A unified strategy engages stakeholders in creating and monitoring policies and research to combat AMR. Through collaboration, One Health works to improve global health and economic resilience against the threats of AMR.
Global Action Plan (GAP) on Antimicrobial Resistance: The Global Action Plan on AMR, adopted in 2015, promotes a One Health approach to combat AMR globally. It urges countries to implement national action plans that integrate multisectoral collaboration. The GAP, endorsed by FAO, WHO, WOAH, and UNEP, shows global commitment to combating AMR. This plan fosters innovative strategies to address AMR challenges across sectors effectively.
Quadripartite Joint Secretariat on AMR: The Quadripartite consists of WHO, FAO, UNEP, and WOAH. Together, these agencies coordinate the global One Health response to AMR. WHO hosts the secretariat that supports initiatives such as the Global Leaders Group and multi-stakeholder platforms. Such efforts foster cooperation among the human, animal, and environmental sectors to mitigate AMR. Established technical working groups strengthen awareness and action against AMR worldwide.
World AMR Awareness Week (WAAW): World AMR Awareness Week (WAAW), celebrated every year from November 18–24, raises awareness about AMR. Launched in 2015, the event unites stakeholders and policymakers to share best practices against AMR. This campaign emphasizes that the One Health approach is an essential tool to address this global threat. WAAW promotes public education and sectoral collaboration to mitigate impacts from AMR effectively.
Global Antibiotic Research and Development Partnership (GARDP): The Global Antibiotic Research and Development Partnership (GARDP) is a collaborative effort between the World Health Organization (WHO) and the Drugs for Neglected Diseases Initiative (DNDi). This partnership is committed to addressing the urgent challenge of antibiotic resistance, with a specific goal of creating and making available five novel therapeutic options by the year 2025. These treatments will specifically target the strains of drug-resistant bacteria that the WHO has classified as the most significant threats to global health.
Major Developments in AMR
· New Antibiotic Offers 10x Efficacy with Just 3 Doses to Combat Drug-Resistant Pneumonia
In November 2024, in a significant advancement for India’s biotechnology industry, Union Minister Dr. Jitendra Singh officially introduced the nation’s first homegrown antibiotic, “Nafithromycin,” aimed at combating resistant infections. This development marks a pivotal moment in the country’s efforts to address the growing challenge of antibiotic resistance. The Minister highlighted that Prime Minister Modi’s direct involvement has streamlined processes and facilitated progress in the biotechnology field, making it significantly easier for scientists and researchers to pursue their work and contribute to the nation’s healthcare solutions.
· Quadripartite launches a new platform to tackle antimicrobial resistance threat to human and animal health and ecosystems
In November 2022, Quadripartite introduced an innovative platform to address the critical issue of antimicrobial resistance, which poses significant risks to human and animal health and ecosystems. This initiative reflects a collaborative effort to enhance global health security and promote sustainable practices. The newly launched platform by Quadripartite is designed to combat the growing threat of antimicrobial resistance, which endangers not only human and animal well-being but also the integrity of various ecosystems. This strategic move underscores the importance of a unified approach in tackling this pressing global challenge.
· Boehringer Ingelheim, Evotec and bioMérieux launch Aurobac, a joint venture to fight Antimicrobial Resistance
In July 2022, Boehringer Ingelheim, a prominent biopharmaceutical organization focused on research and development, has partnered with Evotec SE, a notable entity in the life sciences sector, and bioMérieux, a global frontrunner in in vitro diagnostics. This collaboration aims to establish a joint venture dedicated to innovating the next generation of antimicrobial agents. The newly formed joint venture will concentrate on developing advanced antimicrobials that are complemented by actionable diagnostic tools. This initiative is particularly significant in combating Antimicrobial Resistance (AMR), a growing global health concern that poses serious challenges to effective treatment options.
Government and Global Initiatives
Governments and international organizations are doing much to curb antimicrobial resistance. The WHO’s Global Antimicrobial Resistance and Use Surveillance System provides essential data on resistance trends among countries, guiding decisions.
The European Union has adopted severe policies, like the Farm to Fork Strategy, to reduce antimicrobial use in agriculture by 50% by 2030. In the United States, the Combating Antibiotic-Resistant Bacteria (CARB) Task Force supervises the execution of a national action plan meant to curb the rise of resistant infections.
Meanwhile, public-private partnerships, such as the AMR Action Fund, have pledged more than USD 1 billion to support 2–4 new antibiotics that could be in the pipeline for development by 2030. One can see that greater acceptance of this shared global responsibility of AMR
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