From hospitals facing up to 80% antibiotic resistance to gonorrhoea that is resistant to almost all treatment, antimicrobial resistance (AMR) is a serious and growing problem, countries told the World Health Assembly (WHA) on Tuesday.

But it has been 10 years since the global action plan on antimicrobial resistance was adopted, and the WHA endorsed the World Health Organization’s (WHO) proposal to present an updated plan to next year’s assembly.

This also follows a request from the United Nations High-Level Meeting on AMR last year for an updated global action plan by 2026.

By 2024, over 170 countries reported that they had national AMR action plans, but only 29% of countries had costing, budgeting and monitoring implementation. Member states also reported that a lack of financing and technical capacity are key constraints.

Slovenia outlined the damage already caused by AMR: “In 2021, AMR was linked to nearly five million deaths, over one million directly. This is not a future threat, it’s a present crisis. ”

“A particularly alarming example is drug-resistant gonorrhoea, once easily treatable, it is now resistant to nearly all antibiotics, raising the risk of untreatable infections, infertility and increasing HIV transmission,” said Slovenia.

“Preventing infections is our first line of defence,” added Slovenia, urging countries to focus on “improving infection control, hygiene, waste management and vaccine access” to reduce both infections and antibiotic demand.

‘Critical blindspots’

Bangladesh described AMR “misuse in animal health, pharmaceutical runoff in the environment, and weak regulatory oversight beyond the human health sector” as “critical blind spots that must receive the same priority as the human health interventions”. 

Nigeria’s second national action plan on AMR launched in 2024, focuses on “domestic resource mobilisation and multi-sectoral engagements.”

“With surveillance systems operational in multiple human, animal and environmental health laboratories and a dedicated national budget line now in place, Nigeria has met the who 2025 minimum standards for infection prevention and control (IPC) and is proud to have been recognised in the WHO 2024 global IPC report as a global best practice,” said the country representative.

But Nigeria acknowledged “lingering challenges”, and to address these, it is “prioritising sustainable, innovative financing, decentralised governance and sub-national capacity-building, expansion of surveillance into primary and community health sectors and integrating stewardship efforts across the health system”.

Indonesia told the WHA that it needs support in “strengthening surveillance efforts, laboratory infrastructure and R & D”. It supports an updated plan that will guide AMR “governance, financing, workforce development and concrete strategies to address socioeconomic determinants of AMR”.

Barbados, whose Prime Minister Mia Mottley chairs the Global Leaders Group on AMR, called for accelerated action on AMR and “sustained technical and financial support, especially for small island developing states”. 

Spain, which confessed to being one of the biggest consumers of antibiotics in primary healthcare, said it had implemented controls in 2014 that had slowed this trend. 

“We’ve launched a new plan for 2025-2027 focused on strengthening surveillance, professional training and research and development for new antibiotics and therapeutic alternatives,” Spain told the WHA.

Numerous countries reported financial challenges in addressing AMR, including countries such as Micronesia, whose AMR efforts were supported by the US Centers for Disease Control (CDC)  However, several countries reported getting support from the UK-based Fleming Fund.

The WHO will submit a draft of the updated report to next year’s executive committee.