Threat of AMR – ICARS

The Threat of AMR

If we are to have a chance at achieving the Sustainable Development Goals, we must increase the world’s determination to mitigate AMR.

Antimicrobial Resistance: a global health and development challenge

Antimicrobial resistance (AMR) threatens the effectiveness of antimicrobials essential to modern healthcare, agriculture, and sustainable development. As bacteria, viruses, fungi, and parasites develop resistance to treatments, common infections and routine procedures, such as those used in healthcare or veterinary settings, become increasingly difficult and sometimes impossible to treat. 

AMR and the global health agenda

AMR undermines progress toward the Sustainable Development Goals (SDGs), with implications for human health, agro-food systems, economic development, and the environment. Effective antimicrobials are critical to achieving universal health coverage, ending preventable deaths, and supporting safe food systems. 

In 2019, the World Health Organization named AMR as one of the top 10 global public health threats. In 2022, the Quadripartite organizations (WHO, FAO, UNEP, WOAH) reaffirmed this through a joint commitment to coordinated, multisectoral action under the One Health approach. 

The scale of the problem

  • In 2021, bacterial AMR was linked to 4.71 million deaths, with 1.14 million directly attributed1.
  • Without action, 1.91 million deaths per year could be attributable to AMR by 2050, and 39.1 million cumulatively between 2025 and 20502.
  • The burden is highest in low- and middle-income countries, particularly Sub-Saharan Africa3. 
  • Older adults are most affected: by 2050, nearly 66% of AMR deaths will occur in people aged 70 and above4.

These trends call for urgent, equity-focused action.

Drivers across sectors

The rise of AMR is driven by a combination of factors across sectors, for example: 

  • Humans: Between 2000 and 2015, antimicrobial use increased by 65%, with the use of broad-spectrum “Watch” antibiotics rising 90% globally, and 165% in LMICs5. Other drivers, such as misuse in outpatient settings, over-the-counter access, and inadequate infection prevention and control, also contribute significantly.
  • Animals: Over 70% of antibiotics are used in food-producing animals. Use is projected to grow 50% by 2030, with 25% of countries still permitting antibiotics for growth promotion6.
  • Environment: Pharmaceutical manufacturing discharge, agricultural runoff from both livestock and crop treatments, and inadequate wastewater treatment create environmental reservoirs where resistant bacteria proliferate and exchange resistance genes. 

Economic impact

If left unaddressed, AMR could reduce global GDP by 1.1% to 3.8% annually by 2050 — an economic shock comparable to but longer lasting than the 2008–2009 financial crisis. LMICs are expected to face the most severe economic and health impacts. 

Implementation gaps

178 countries have developed national action plans on AMR7. However, despite this growing recognition of the problem: 

  • Only 27% report effective implementation8.
  • And just 11% have dedicated budgets in place9. 

Bridging the science-policy gap and then translating policy into action, while improving coordination across sectors and borders, is critical. Importantly, this involves not only ensuring that evidence informs policy, but also that policy is effectively translated into implementation.  

A window of opportunity

Despite the alarming projections, the potential for action is significant: 

  • 92 million deaths could be averted through improved access to care and infection prevention by 205010.
  •  According to a WHO Study, vaccines against 23 pathogens could reduce the number of antibiotics needed by 22% globally every year11.

ICARS' role

ICARS works in close partnership with low- and middle-income countries to design, implement, and scale context-specific solutions that reduce drug-resistant infections. The focus is on intervention and implementation research, capacity strengthening, and supporting sustainable change across sectors under the One Health framework. 

Join ICARS

Reducing AMR requires a global effort. Countries, funders, and foundations are invited to partner with ICARS to co-create effective, lasting solutions.