Antimicrobial resistance (AMR) is advancing more quickly than many health systems can manage. The global picture is deeply concerning.
Bacterial AMR alone will cause 39 million deaths between 2025 and 2050, which equals three deaths every minute, according to a study funded by Wellcome and the United Kingdom Department of Health and Social Care’s Fleming Fund.
The report published in the journal Lancet cited an estimated 1.27 million deaths in 2019 directly caused by antibiotic resistant infections and nearly 5 million associated deaths. Sub-Saharan Africa and South Asia carry the heaviest burden due to high prevalence of critical infections and limited diagnostic capacity.
India reflects both the risk and the possibility within this challenge. The country has the expertise and urgency to influence global progress but efforts must be communicated clearly to both experts and the wider public.
Why LMICs face higher risks
Many low- and middle-income countries (LMIC) struggle with widespread availability of antibiotics without prescriptions, circulation of counterfeit or substandard drugs and inadequate sanitation. These conditions accelerate resistance.
The most significant barrier is the lack of affordable and reliable diagnostics. In many hospitals traditional culture methods take two to three days. The absence of diagnostic capacity often leads to broad spectrum antibiotic use, explained Otridah Kapona from the Zambia National Public Health Institute. This approach fuels resistance and prevents clinicians from choosing the correct treatment.
Community clinics experience similar problems. Rapid tests that can distinguish between bacterial and viral infections are often unaffordable. C-reactive protein tests are widely used but they cannot differentiate between bacterial infections and illnesses such as malaria, dengue or COVID-19. This gap results in unnecessary antibiotic use for fevers that have viral or non-bacterial causes.
Limited diagnostic capacity means fewer samples are tested and resistance trends remain unclear. Without reliable laboratory results, hospitals cannot build accurate treatment guidelines.
Cecilia Ferreyra from the Foundation for Innovative New Diagnostics noted that the absence of quick diagnostics prevents clinical teams from knowing what type of pathogen is present and how resistant it may be. This affects prescribing decisions and surveillance quality. As a result, national-level AMR data in many LMICs remains incomplete.