Antimicrobial resistance (AMR) occurs when microorganisms—including bacteria, viruses, fungi, and parasites—evolve to resist drugs designed to kill them. This makes infections harder or impossible to treat, undermining decades of progress in medicine. AMR already causes an estimated 1.27 million deaths annually and is associated with nearly 5 million, surpassing malaria and HIV. Projections suggest it could cause up to 10 million deaths per year by 2050, largely in low- and middle-income countries (LMICs), though the burden is rising globally, especially among older populations.

Key drivers include overuse and misuse of antimicrobials in healthcare, agriculture, and manufacturing, poor infection control, and lack of diagnostic tools. While AMR is unlikely to directly cause a catastrophic pandemic, it can amplify the impact of viral pandemics through untreatable secondary infections. Major challenges include drying R&D pipelines for novel antibiotics, underfunded national action plans, and poor global coordination. Promising interventions include “pull” funding mechanisms to incentivize drug development, improved surveillance and diagnostics, and stronger stewardship. AMR is a One Health issue requiring cross-sector coordination and remains significantly neglected given its global threat level.