The global challenge of antimicrobial resistance

The medicines that made once-deadly infections routine are quietly losing their power. It is among the most serious slow-moving threats in medicine.

For most of the last century, a bacterial infection meant a course of antibiotics and, usually, recovery. That reliability, one of medicine's quiet miracles, is eroding.

The scale of the threat

In 2019, an estimated 1.27 million deaths were directly attributable to bacterial antimicrobial resistance, and nearly 4.95 million deaths were associated with it worldwide.¹ The World Health Organization has named antimicrobial resistance one of the top ten global public-health threats facing humanity.

The medicines still exist. It is the bacteria that have changed.

How it happens

Every time an antibiotic is used, the bacteria best able to survive it are the ones that persist and multiply. Over time, accelerated by overuse and misuse in both medicine and agriculture, resistant strains come to dominate, and drugs that once worked reliably begin to fail.

A quiet emergency

Unlike a pandemic, resistance advances slowly and invisibly, which is part of what makes it so dangerous. The estimates rest on an enormous evidence base, 23 pathogens and 88 pathogen–drug combinations across 204 countries and territories.¹ The threat is not hypothetical; it is already here.

Why it matters

Antimicrobial resistance touches nearly all of modern medicine (surgery, cancer care, childbirth), each of which depends on our ability to control infection. Preserving that ability, through careful stewardship and new approaches, is among the defining challenges of the field.