Antimicrobial resistance (AMR) governance is strengthening worldwide, but improvements in national policy frameworks have not yet translated into meaningful reductions in drug-resistant infections.
AMR occurs when microbes evolve to survive medicines that once killed them, making infections harder to treat. It is considered a pressing global health threat.
A large global analysis developed a new AMR governance index, assessing 193 countries between 2017 and 2022. Governance scores improved, rising from 30.7 to 44.5 out of 100. However, policy design has advanced faster than implementation, with monitoring systems and practical measures lagging, particularly in agriculture and environmental sectors.
Despite stronger governance, measurable AMR outcome improvements are slow. Statistical modeling suggests resistance level changes are not detectable until around 5 years after national action plans are introduced. This delayed effect highlights the complexity of controlling AMR.
Key drivers of progress include early multisector engagement, integrating human health, veterinary, and environmental sectors, and strong antimicrobial use surveillance systems. Progress varied widely by region, with European countries generally demonstrating stronger systems.
Implications for global AMR strategy emphasize the need for sustained funding, integrated surveillance, and stronger engagement with environmental and agricultural stakeholders to translate governance improvements into real reductions in antimicrobial resistance.