The Global Landscape of Antibiotic Resistance

The risk of antibiotic resistance isn’t evenly distributed across the globe. The WHO estimates the highest levels of resistance are concentrated in the South-East Asian and Eastern Mediterranean Regions, where approximately one in three reported infections are now resistant to treatment. The African Region faces a similarly concerning situation, with one in five infections proving unresponsive to antibiotics. Critically, resistance is more prevalent and worsening in areas with limited healthcare infrastructure and diagnostic capabilities.

“Antimicrobial resistance is outpacing advances in modern medicine, threatening the health of families worldwide,” stated Dr. Tedros Adhanom Ghebreyesus, WHO Director-General. “Strengthening surveillance systems is paramount, but we must also prioritize responsible antibiotic use, ensure equitable access to effective medicines, quality diagnostics, and vaccines, and invest in innovative solutions like next-generation antibiotics and rapid testing.”

Gram-Negative Bacteria: The Forefront of the Crisis

The report highlights a particularly worrying trend: the increasing resistance of Gram-negative bacteria. These pathogens, including Escherichia coli (E. coli) and Klebsiella pneumoniae, are responsible for many severe bloodstream infections, often leading to sepsis, organ failure, and death. Alarmingly, over 40% of E. coli and more than 55% of K. pneumoniae globally now demonstrate resistance to third-generation cephalosporins, typically the first-line treatment for these infections. In the African Region, this resistance climbs to over 70%.

The effectiveness of other crucial antibiotics, such as carbapenems and fluoroquinolones, is also waning against E. coli, K. pneumoniae, Salmonella, and Acinetobacter. Carbapenem resistance, once a rare occurrence, is becoming increasingly common, leaving healthcare providers with limited treatment options and often forcing reliance on costly, difficult-to-access, last-resort antibiotics – resources often unavailable in low- and middle-income countries.

Did You Know? The overuse and misuse of antibiotics in both human and animal health are major drivers of antibiotic resistance. Even seemingly minor infections treated with antibiotics when they aren’t needed contribute to the problem.

Progress in Surveillance, But Challenges Remain

Despite the grim outlook, there has been positive progress in global surveillance efforts. Participation in GLASS has quadrupled since 2016, growing from 25 to 104 countries in 2023. However, nearly half of all countries (48%) did not submit data to GLASS in 2023, and approximately half of those reporting lacked the robust systems needed to generate reliable data. The countries facing the greatest challenges with antibiotic resistance are often the same ones lacking the capacity to accurately assess the situation.

The political declaration on AMR adopted by the United Nations General Assembly in 2024 establishes targets for addressing AMR through strengthened health systems and a “One Health” approach – coordinating efforts across human, animal, and environmental sectors. To effectively combat this growing challenge, countries must prioritize strengthening laboratory infrastructure and generating reliable surveillance data, particularly in underserved areas, to inform treatment guidelines and policies.

The WHO is urging all nations to report high-quality AMR and antimicrobial use data to GLASS by 2030. Achieving this goal requires a concerted effort to improve data quality, expand geographic coverage, and facilitate data sharing to track progress effectively. Countries must also scale up coordinated interventions across all levels of healthcare and ensure that treatment guidelines and essential medicines lists align with local resistance patterns.

Further information and interactive data visualizations are available on the WHO’s GLASS dashboard.

What role do you believe individual citizens can play in slowing the spread of antibiotic resistance? And how can international collaboration be improved to address this global health threat?

The WHO’s Global antibiotic resistance surveillance report 2024 provides a comprehensive overview of the current state of antibiotic resistance worldwide.

Addressing antibiotic resistance requires a multi-faceted approach, including responsible antibiotic stewardship, improved infection prevention and control, and investment in research and development of new antibiotics and diagnostic tools. The future of healthcare depends on our collective ability to confront this challenge head-on.

For more information on antibiotic resistance and its impact, visit the Centers for Disease Control and Prevention (CDC) website and the European Medicines Agency (EMA) website.

Frequently Asked Questions About Antibiotic Resistance