Antimicrobial Resistance – The Silent Crisis – Asrar Qureshi’s Blog Post #1192

Antimicrobial Resistance – The Silent Crisis – Asrar Qureshi’s Blog Post #1192

Dear Colleagues! This is Asrar Qureshi’s Blog Post #1192 for Pharma Veterans. Pharma Veterans Blogs are published by Asrar Qureshi on its dedicated site https://pharmaveterans.com. Please email to pharmaveterans2017@gmail.com  for publishing your contributions here.

Credit: Anna Shvets

Credit: Gustavo Fring

Preamble

Antimicrobial resistance (AMR) is no longer a distant possibility; it is already here. According to the WHO, drug-resistant infections are increasingly undermining medical progress worldwide. Every year, more than a million lives are lost because once-reliable antibiotics and other antimicrobials are failing. Worse still, without concerted global action, that number is set to rise dramatically.

AMR is not just a public-health concern: it’s a signal of deep structural weaknesses in how we produce, deploy, commercialize, regulate, and steward antimicrobial drugs.

It calls for a wholesale rethink, from drug development to distribution, regulation to stewardship, and from public-health infrastructure to live farming to livestock.

In this post, I present key messages from the WHO’s recent warnings and explore what they mean, especially for pharma managers in our country and region, where the stakes are high.

What is AMR and why is it becoming an existential threat?

At its core, AMR happens when bacteria, viruses, fungi or parasites evolve or acquire the ability to survive treatments that used to kill them. As a result, common infections, once easily treatable, become difficult, sometimes impossible, to cure. What used to be standard surgery or childbirth antibiotics can no longer be relied upon.

This is not a gradual problem. According to WHO, AMR already causes more than a million deaths each year globally. And those figures only account for confirmed resistant cases; the real toll may be higher, especially in low-resource settings where diagnostics and reporting are weak.

Beyond death and suffering, AMR threatens to undo decades of medical gains: the reliability of antibiotics underpins not only treatments for common infections, but also major advances in surgery, cancer therapy, neonatal care, and much more.

A Global, Multi-Sector Threat – Not Just a Clinical Problem

One striking insight from the recent WHO message is that AMR does not respect sectors. It is not only a hospital or clinical challenge. It spans human health, veterinary medicine, agriculture, environmental hygiene, food systems, community behavior, and more. 

This underscores a central truth: combating AMR requires a “One Health” approach, integrating human health, animal health, agriculture and environment. Whether it is a hospital strengthening antimicrobial stewardship, or a farm controlling antibiotic use in livestock, or a community improving sanitation, every stakeholder matters.

For countries in South Asia, where dense population, high infectious-disease burden, widespread agriculture and livestock rearing exist together, this multifaceted threat is especially acute.,

The Promise, and the Peril of High-Level Commitments

In 2024, at a UN General Assembly high-level meeting on AMR, world leaders signed a political declaration committing to concrete targets: most notably, a global aim to reduce deaths associated with bacterial AMR by 10% by 2030 (using 2019 as baseline).

This marks a major shift: from passive warnings to active accountability. The declaration includes commitments to:

• Strengthen national AMR surveillance systems (human and animal)

• Improve access to quality antimicrobials and diagnostics

• Encourage innovation, research and development for new drugs

• Mobilize sustainable financing, including from domestic budgets and international donors, to support AMR responses.

But political commitment alone is not enough. The challenge now is translating those declarations into measurable, on-the-ground interventions. As the WHO notes, turning “talk into action” is the only way to safeguard the future of antimicrobials.

Why the Time for Pharma Industry Leadership Is Now

As someone with decades inside the pharmaceutical industry, I understand that industry plays a dual role in the AMR crisis, and in the solution.

The pipeline is drying out. Recent analyses show that the global pipeline for new antibiotics is inadequate. While AMR spreads, the number of novel antimicrobial drugs under development remains too small to offset rising resistance.

This is a market failure. Antibiotics are among the least profitable categories for drug developers (especially compared to chronic medications or lifestyle drugs). But without renewed innovation, we risk returning to a pre-antibiotic era.

The economics of prevention far outweigh treatment. Studies cited by WHO and international agencies show that the return on investment (ROI) for AMR prevention and stewardship is high: every dollar invested in key interventions could return 7–13 dollars, by avoiding costs of lost productivity, increased healthcare burden, and mortality.

For pharma companies and health systems, especially in low- and middle-income countries (LMICs), this makes AMR response not only a moral imperative, but a strategic economic opportunity.

If we want to preserve antimicrobials for future generations, the pharmaceutical industry must lead by investing in R&D, by supporting stewardship and access programs, and by cooperating with global public-health and regulatory agencies.

In South Asia, where regulatory oversight is often weaker, such leadership, especially from major local or regional players, could influence policies, guide responsible use, and improve access.

What Pharma Leadership Should Do

a) Advocate for and invest in R&D for next-generation antimicrobials

Given the shrinking antibiotic pipeline, private-sector investment (or public-private partnerships) is critical. Pharma companies should re-evaluate their R&D priorities and consider long-term value over short-term profits.

b) Support national and regional stewardship programs

Help health authorities and hospitals adopt antimicrobial stewardship, including but not limited to, rational prescribing, diagnostics before prescription, surveillance of resistance trends. Also support efforts to regulate antibiotic use in livestock and agriculture.

c) Engage in policy advocacy and capacity building

Use their voice and experience to push for government policies in the country, e.g., national AMR action plans, surveillance systems, stewardship guidelines, farmer training for responsible antibiotic use, regulation of over-the-counter antibiotic sales.

d) Raise awareness among professionals and public

Leverage your platform to highlight the urgency of AMR, showcase success stories, critique systemic gaps, and propose solutions. Awareness remains a weak link in many LMICs.

e) Collaborate across sectors – embrace “One Health”

Encourage cooperation not only with hospitals and regulators, but also with veterinary, agriculture, environmental and community stakeholders. This is not just a hospital problem; it is a societal challenge.

What Has Changed and Why Now Could Be a Turning Point

There are reasons to hope that now may be a turning point in the fight against AMR:

The 2024 UN high-level meeting raised political commitment globally; the 2030 target creates a roadmap and accountability framework.

The call from WHO and partner agencies to “turn commitments into life-saving interventions”, strengthening surveillance, enhancing access, stimulating innovation, is more concrete than past advocacy.

The global health and development sector increasingly recognizes AMR as not just a health problem, but also a development, economic, and security issue.

For South Asia in particular, a region with high infectious-disease burden, dense populations, widespread antimicrobial use (both in humans and livestock), and varying regulatory environments, the urgency and opportunity are particularly high.

Pharma companies that act now, invest responsibly, and align with global and regional AMR strategies can play a leading role, and position themselves as ethical and strategic players in global health.

Sum Up

The menace of antimicrobial resistance is no longer hypothetical. It is here, quietly, persistently, and destructively, undermining decades of medical progress.

The call from the WHO and its global partners is loud and clear: we must act now. Protect antimicrobials today, to secure the future of medicine tomorrow.

For pharma industry, this is a defining moment. The choices made today will determine whether we preserve the effectiveness of antimicrobials or inadvertently usher in a post-antibiotic age.

If the last century was defined by the rise of antibiotics, let this next decade be defined by our resolve to protect them.

Concluded.

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For most blogs, I research from several sources which are open to public. Their links are mentioned under references. There is no intent to infringe upon anyone’s copyrights. If, any claim is lodged, it will be acknowledged and duly recognized immediately.