Dar es Salaam. The World Health Organization (WHO) declared antimicrobial resistance (AMR) a top 10 global public health threat in 2019, citing 4.95 million deaths associated with bacterial AMR across 204 countries in that year.
Despite ongoing global efforts, health experts warn that antimicrobial resistance continues to threaten health systems worldwide, with many countries at risk of losing ground unless governments urgently strengthen financing, accountability and implementation of national action plans.
According to the latest assessment by the WHO Eastern Mediterranean Regional Office (WHO EMRO), most countries have developed national action plans to address AMR.
However, implementation remains slow and fragmented due to inadequate funding, weak monitoring systems and poor enforcement of regulations governing antibiotic use.
The report cautions that without reliable domestic financing and stronger political commitment, progress in tackling drug-resistant infections will remain limited, particularly in low- and middle-income countries with fragile health systems.
Experts note that although many countries have introduced regulations on the sale of antibiotics, enforcement remains weak in most settings.
Inappropriate antibiotic use continues, especially in primary healthcare facilities where most prescriptions are issued.
The WHO EMRO assessment calls for strengthened antimicrobial stewardship programmes through improved training of healthcare workers, enhanced monitoring systems and the use of digital tools to track antibiotic sales and prescribing patterns.
“Most countries have a national action plan, but implementation is lagging.
The next phase must focus on costing and budgeting these plans and establishing a clear monitoring and evaluation system,” the report states.
The findings also show that although surveillance systems have expanded in recent years, many countries are still not consistently using AMR data to guide procurement, prescribing practices or policy decisions.
Health experts are also urging the adoption of a fully integrated “One Health” approach linking human, animal, food and environmental health systems to address antimicrobial resistance comprehensively. However, WHO EMRO notes that implementation remains fragmented, with environmental surveillance identified as the weakest component.
The report further highlights ongoing shortages in trained personnel, warning that many countries lack sufficient workforce capacity to support effective AMR surveillance, stewardship and infection prevention programmes.
It recommends that governments elevate AMR to a national priority, supported by dedicated budget allocations and stronger accountability mechanisms beyond ministries of health.
The assessment also stresses that global investments in antimicrobial research and development should be aligned with national regulatory systems, local pharmaceutical production and procurement frameworks.
Experts further emphasise the need to increase investment in diagnostics and preventive tools to reduce unnecessary antibiotic use and preserve the effectiveness of existing medicines.
The warning comes at a time when conflicts, climate change and weak health systems are accelerating the spread of drug-resistant infections globally.
The WHO EMRO concludes that antibiotics should not be treated as commercial commodities but as essential public health assets requiring sustained political commitment, reliable financing and cross-sector accountability to safeguard their effectiveness for future generations.
