Antimicrobial resistance: The complex challenge of measurement to inform policy and the public

Antimicrobial resistance (AMR) is increasing in a wide range of pathogens, causing morbidity and mortality globally, and threatening modern medicine. While the long-term impact of AMR on human societies remains uncertain [1], the conservation of antimicrobials’ effectiveness has become an urgent priority. Tackling this ubiquitous problem requires coordination among countries and across sectors that include human and animal health, the environment, development, and trade. Previous attempts at orchestrating such a response have been insufficient, but growing concern about AMR culminated in the adoption of a Global Action Plan (GAP) by the World Health Organization (WHO) in 2015 [2], followed by a political declaration at the General Assembly of the UN in 2016 [3]. Both documents recognize AMR as an interlinked biological and social problem driven by rising world population, exacerbated by the misuse of antimicrobials in human and animal health, compounded by globalization, and made more pressing by the lack of development of new drugs. In many developing countries, a high burden of infectious diseases, rising consumption in human and animal health, limited access to quality medicine, and poor public health infrastructure create conditions for the problem to worsen [4]. Governments, which have the ultimate responsibility to tackle the problem, have now started to deliver their national strategies based on the GAP [5]. To support implementation of the GAP, we see an immediate need to expand monitoring of countries’ commitments through an integrated approach to measure AMR.