Antimicrobial Resistance: A Global Health Threat and Strategies for Containment

Abstract

Antimicrobial resistance [AMR] is a major global health crisis caused by evolutionary mechanisms such as enzymatic degradation, efflux pumps, decreased permeability, and horizontal gene transfer that render conventional therapies ineffective against bacteria, viruses, fungi, and parasites. AMR was accelerated by overuse and misuse of antimicrobials in human medicine, agriculture, and veterinary practice, and exacerbated by globalization, inadequate infection prevention, and socioeconomic disparities in low- and middle-income countries [LMICs], resulting in 1.27 million direct deaths in 2019, with projections of 10 million annual fatalities and more than $100 trillion in economic losses by 2050. This review explains AMR's epidemiology, which disproportionately affects LMICs with up to 90% of global mortality; its clinical consequences, such as prolonged hospitalizations, disrupted surgeries, and increased risks for immunocompromised patients; and key drivers such as self-medication and environmental contamination. Surveillance systems, such as the WHO's GLASS, as well as stewardship programs, vaccination, awareness campaigns, and infection control, have resulted in resistance reductions [for example, a 30% drop in inpatient antibiotic use in the United States], while novel paradigms phage therapy, CRISPR-Cas gene editing, nanoparticles, and host-directed therapies provide precision alternatives with minimal selective pressure. Policy frameworks, such as the WHO Global Action Plan and One Health integration, support multisectoral responses, but ongoing obstacles such as R&D underfunding, access disparities, and fragmented collaboration necessitate immediate, equity-focused investments. Global action aimed at meeting UNGA goals by 2030 might save 92 million lives, changing AMR from an existential threat to a controllable imperative through innovation, surveillance, and inclusive governance.