Antimicrobial resistance occurs when bacteria, viruses, fungi, and other microbes develop resistance to the medicines used to treat infections and diseases. Often, this resistance is due to the improper or overuse of antimicrobial drugs. AMR leads to longer periods of illness and prolonged stays in hospitals, increased mortality, and greater health care costs.
The Centers for Disease Control and Prevention cite AMR as one of the greatest public health challenges today. Each year in the United States, at least 2.8 million people are infected with an antimicrobial-resistant infection, leading to more than 35,000 deaths. 
It is estimated that by 2050, 10 million lives a year and $100 trillion in economic output will be lost due to AMR.  Low- and middle-income countries will be affected the most by AMR.
Combatting AMR requires a reduction in the usage of antibiotics, improved infection prevention and control measures especially in health care facilities, greater access to water and sanitation, and the development of new treatments.
While new antibiotics and other tools are desperately needed to address drug-resistant infections, research and development of these tools has not kept pace with rising resistance. Many private sector research entities have abandoned antibacterial research and development deemed unprofitable—meaning public investment in these public health essentials is urgently needed.
Support One Health policies that reduce reliance on antimicrobials. AMR is a One Health challenge — it affects the health of people, animals and the environment. The usage of antibiotics in agriculture and in livestock has led to antibiotic-resistant germs that can infect human populations. Addressing AMR will require solutions that are multisectoral and holistic.
Support programs that ensure sustainable access to safe water and proper sanitation and hygiene. Access to water, sanitation and hygiene is critical to infection prevention and control measures such as hand-washing and wastewater management, which help to prevent and contain the spread of infections and other diseases.
Support the development of new medicines, diagnostics and vaccines. Several U.S. government agencies support the research, development and deployment of new tools to address drug resistance, as well as the monitoring needed to assess where increasing resistance requires the introduction of new tools. These agencies—including the CDC, Biomedical Advanced Research and Development Authority, U.S. Agency for International Development, and National Institutes of Health—should be robustly funded for their unique capabilities and encouraged to coordinate and collaborate in accordance with the National Action Plan for Combating Antibiotic-Resistant Bacteria (CARB), 2020-2025.
Photo Credit: Mark Fletcher-Brown
Photo Credit: Medtronic Foundation
The introduction of antibiotics and other antimicrobials was a game changer in modern medicine. Without them, procedures such as organ transplants, dialysis, chemotherapy and the treatment of chronic diseases put patients at risk for infections. The rise of “superbugs,” or resistant microbes, again puts patients at risk. Today, a growing number of infections are only treatable using last-resort treatments that are often more toxic, lead to longer hospital stays, or result in death.
For human health, ensuring effective infection prevention and control measures are in place in health care facilities, households, schools, and markets is critical to preventing and containing the spread of diseases and infections, and therefore the need to use antibiotics. Many drug-resistant infections are acquired in health care settings, and health systems should be adequately supported to ensure proper hygiene practices, such as hand-washing, cleaning and sanitation.
In 2016, the U.S. government—via the BARDA and the National Institute of Allergy and Infectious Diseases—joined with Wellcome Trust to launch CARB-X, a global nonprofit partnership dedicated to accelerating antibacterial research. Since its inception, this partnership—which is led by Boston University and now financed by additional global partners—has supported 75 diverse projects across 10 countries with its portfolio now representing the world’s largest early development pipeline of antibacterial innovations. With several of these projects progressing and meeting research milestones, CARB-X is fueling an expanding pipeline of next-generation tools to respond to the urgent health threat of AMR.
In 2018-2019, the U.S. government supported the AMR Challenge, in which over 350 organizations from around the world pledged to work to slow AMR through five pillars of action: tracking and data; infection prevention and control; antibiotic use; environment and sanitation; and vaccines, therapeutics and diagnostics.  The AMR Challenge provides an example of a holistic and multisectoral approach to addressing AMR.
CDC Antibiotic Resistance/AMR: https://www.cdc.gov/drugresistance/index.html
Danielle Heiberg, Global Water 2020, email@example.com
Emily Conron, Global Health Technologies Coalition, firstname.lastname@example.org
HEADER PHOTO CREDIT: Medtronic Foundation