Race Against Resistance

From minor infections becoming untreatable to lifesaving procedures turning perilous, AMR impacts every aspect of human, animal, and environmental health. With projections of 10 million deaths annually by 2050, the need for urgent, collective action cannot be overstated..
By Dr Suneela Garg and Dr Arvind Garg

Antimicrobial resistance (AMR) is an escalating global public health crisis that poses a profound threat to the health of humans, animals, and the environment. It occurs when microorganisms such as bacteria, viruses, fungi, and parasites develop resistance to antimicrobial medicines, including antibiotics, antivirals, antifungals, and antiparasitics. As a result, infections that were once easily treatable become harder or even impossible to manage. This resistance leads to prolonged illnesses, increased transmission of diseases, severe disability, and a rising number of fatalities.
The misuse and overuse of antimicrobials in humans, animals, and agriculture are the primary factors driving the development and spread of drug-resistant pathogens. Addressing this crisis demands immediate and comprehensive action across all sectors of society, including healthcare, agriculture, and the environment.
World Antimicrobial Resistance Awareness Week
The World Antimicrobial Resistance Awareness Week (WAAW) is observed annually from 18–24 November. This global initiative aims to raise awareness about AMR, educate stakeholders across the spectrum of human, animal, plant, and environmental health, and advocate for measures to curb the emergence and spread of resistant pathogens.
This year’s theme, “Educate. Advocate. Act Now,” underscores the urgency of the issue, urging the global community to take immediate action. The campaign calls for educating policymakers, healthcare providers, and the public, advocating for bold commitments, and implementing tangible, actionable strategies to combat AMR.

The Devastating Impact of AMR
AMR is responsible for an alarming toll on human health. In 2019, it directly caused 1.27 million deaths worldwide and contributed to an additional 4.95 million deaths. These numbers are projected to worsen if no significant action is taken. By 2050, AMR could lead to the deaths of 10 million people annually, surpassing the mortality rates of major diseases like cancer.
Beyond its human toll, AMR has severe economic consequences. It is estimated that the global cost of AMR could reach USD 3.4 trillion annually by 2030, pushing 28 million people into poverty. The financial burden is exacerbated by prolonged hospital stays, the need for more expensive treatments, and loss of productivity due to illness and disability.
Patients with pre-existing conditions such as cancer, diabetes, or HIV are particularly vulnerable, as AMR compounds their susceptibility to infections. Routine medical procedures, such as caesarean sections, organ transplants, and chemotherapy, become significantly riskier due to the potential for untreatable infections. Even individuals in good health are not immune, as minor injuries or common infections could escalate into life-threatening conditions.

A Silent Epidemic with a Global Reach
AMR knows no borders. Like the COVID-19 pandemic, it is a transnational threat requiring coordinated global action. No single country can combat AMR in isolation. Collaborative efforts are essential to track resistance patterns, identify high-burden regions, and develop targeted interventions.
Proposals for an international treaty on AMR have been put forth to establish a unified framework for addressing this crisis. A global tracking system is also being considered to monitor resistance levels and guide policy decisions. The United Nations General Assembly (UNGA) High-Level Meeting on AMR in 2024 provides a critical platform for world leaders to commit to these measures and take decisive action.
Addressing AMR Across Sectors
Efforts to combat AMR must be inclusive and multi-sectoral. The concept of One Health, which integrates human, animal, and environmental health, is central to these initiatives. Reducing the overuse and misuse of antimicrobials across all domains is crucial.
At an individual level, practical measures can significantly reduce the spread of AMR. Vaccination is one of the most effective strategies, as it prevents infections and thereby reduces the reliance on antibiotics. Good hygiene practices, such as regular handwashing with soap, are fundamental in preventing infections. Safe food handling practices—such as thoroughly cleaning hands, surfaces, and utensils during food preparation—play a key role in preventing foodborne illnesses. Antibiotics should only be used when prescribed by a healthcare professional, and the prescribed course should always be completed to prevent resistance from developing. Sharing or using leftover antibiotics should be strictly avoided. Wounds and cuts should be cleaned properly and kept covered until fully healed to minimise the risk of infection. Additionally, managing chronic conditions such as diabetes or heart disease effectively reduces susceptibility to infections and the subsequent need for antibiotics.
Healthcare providers are at the forefront of the fight against AMR and have a critical role in this battle. They must prescribe antibiotics judiciously, ensuring they are only used when absolutely necessary. Educating patients about the correct use of antimicrobials is essential to foster better understanding and compliance. Strict adherence to infection prevention protocols, including hand hygiene and the sterilisation of medical equipment, is non-negotiable. Quarantining patients with drug-resistant infections can help prevent the spread of these pathogens within healthcare settings and communities.

The Impact on Food Security
AMR also poses a significant threat to global food security. Drug-resistant infections can spread through the food chain, impacting both animal and human health while causing substantial economic losses in the agricultural sector. Overuse of antibiotics in livestock farming is a major contributor to the problem, further complicating efforts to ensure sustainable food production.

Human Stories Behind the Statistics
While the numbers illustrate the magnitude of the AMR crisis, the human stories behind these statistics are equally compelling. Survivors of drug-resistant infections often endure prolonged suffering, financial hardship, and emotional trauma. Advocacy efforts by survivors and their families have helped put a human face on the AMR crisis, raising awareness and inspiring action against this invisible but deadly threat.

Takeaways
AMR is one of the greatest challenges of our time, threatening to reverse decades of medical progress. Governments, non-governmental organisations (NGOs), healthcare professionals, academic institutions, and civil society must unite to combat this crisis. The time for action is now. By addressing AMR with the urgency it demands, we can protect the health and well-being of current and future generations.

(The authors are Chair, Programme Advisory Committee, National Institute of Health & Family Welfare, and Director, Child Care Clinic & Head of Paediatrics, Apollo Hospital, Noida.)