Antimicrobial resistance (AMR) poses a significant threat to health and development, particularly in the Global South.
Despite the adoption of National Action Plans, challenges in implementation persist due to limited resources and awareness.
Collaborative efforts and innovative solutions are essential to address AMR effectively.
Antimicrobial resistance (AMR) has emerged as one of the defining health and development challenges of our time. The silent spread of resistant bacteria, viruses and parasites threatens the effectiveness of essential medicines, undermines food security, and increases poverty and inequality particularly in the Global South. While the world recognises AMR as a global crisis, its burden and drivers are not evenly distributed.
In Africa and Asia, where the human, animal and environment interface is closely intertwined with livelihoods, antibiotics remain critical not only for saving lives but also for sustaining agriculture and income. Yet, misuse and overuse across sectors continue to fuel resistance, calling for more locally driven, integrated, and equitable responses.
Since the adoption of the Global Action Plan on AMR in 2015, over 170 countries have developed National Action Plans. Many low- and middle-income countries (LMIC) have embraced the One Health approach, recognising that AMR cannot be addressed in isolation from food systems, animal health, and the environment.
However, translating these ambitious plans into tangible results remains a challenge. Implementation often falters due to limited financing, weak laboratory networks, fragmented governance, and low awareness among prescribers and end users. In several countries, antibiotics are still easily available without prescription, used in animal production for growth promotion, or disposed of in the environment without control.
Reliable data is the foundation for effective action. Yet, surveillance of AMR and antimicrobial use remains uneven across LMICs. Many laboratories lack basic diagnostic capacity, reagents and information systems to generate and share data. Where data is available, it often remains siloed within sectors, hindering comprehensive analysis and response.
Regional and global efforts are helping to close these gaps. Initiatives such as WHO’s GLASS, FAO’s InFARM and WOAH’s ANIMUSE platform are enabling countries to submit harmonised data and build capacity for evidence-based decision-making.
While surveillance reveals the scale of the problem, stewardship provides the solution. Antimicrobial stewardship (AMS) must extend beyond hospitals to farms, veterinary clinics, pharmacies, and communities. Yet, in many LMICs, stewardship challenges are deeply rooted in systemic constraints.
Farmers and animal health workers often rely on antibiotics as a substitute for good husbandry, vaccination or biosecurity. In the absence of affordable diagnostics, empirical treatment becomes the norm, reinforcing dependence on antibiotics.
Similarly, in human health, limited access to qualified prescribers and diagnostic tools leads to unnecessary or incomplete antibiotic use. These practices are not merely the result of negligence but reflect structural realities economic pressures, lack of knowledge, and limited service delivery options.
Embedding stewardship into systems therefore requires a combination of education, regulation and incentives. It starts with integrating prudent antimicrobial use principles into medical, veterinary and para-veterinary curricula, ensuring that future professionals understand both the science and social context of resistance. Continuous professional training and mentorship are equally important to sustain these practices in the field.
At the same time, private sector engagement is indispensable. Agrovet dealers, pharmacists and feed suppliers play a central role in antibiotic access and distribution across the Global South. Rather than treating them as part of the problem, they should be equipped and incentivised to become champions of responsible dispensing, record-keeping, and client education. Complementary to this, improved access to vaccines, diagnostic services, and affordable alternatives can reduce unnecessary antibiotic reliance.
The future of AMR control lies in innovation, scientific, social and policy-driven. Promising examples are emerging across the Global South, like community-based surveillance programmes that combine human and animal data, digital tools for tracking antimicrobial use, and pilot initiatives providing farmers with biosecurity starter kits and alternatives to growth promoting antibiotics.
Local production of quality assured veterinary and human medicines, alongside regional procurement mechanisms, can also improve access and reduce dependence on informal markets. Importantly, innovation must be inclusive grounded in the realities of smallholder farmers, informal health providers, and under-resourced laboratories.
Collaborations among governments, academia, civil society and private actors are already showing results. These partnerships illustrate that when knowledge and resources are shared equitably, even resource-limited settings can demonstrate leadership in global AMR control.
The AMR crisis is often described as complex, but complexity should not paralyse action. The Global South holds unique strengths, for instance strong community networks, adaptable local systems, and growing scientific capacity. What is needed now is to connect these assets through stronger One Health governance, steady financing and a renewed culture of stewardship.
As the world remembers World Antimicrobial Awareness Week 2025, the Global South must not be viewed merely as a region of vulnerability, but as a region of innovation and resilience. Across Africa, Asia and Latin America, countries are generating solutions that blend science, community engagement and policy pragmatism.
Dr Peter Mwale is a veterinarian with Ministry of Agriculture Malawi and head of the microbiology laboratory at the Central Veterinary Laboratory. He also serves as the national AMR focal point for animal health. Views expressed are the author’s own and don’t necessarily reflect those of Down To Earth.