One Health Trust’s Ramanan Laxminarayan co-authored an article that outlines progress made by the 11 Member States of the World Health Organization South-East Asia (SEA) Region — Bangladesh, Bhutan, North Korea, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand, and Timor-Leste — in mitigating the burden of antimicrobial resistance (AMR). Although all SEA Region Member States have developed and endorsed respective national action plans (NAPs) against AMR, recent data indicate that progress has been fragmented and complicated by a lack of technical capacity, resource limitations, and the COVID-19 pandemic.

In 2020, the United Nations’ Sustainable Development Goals (SDGs) incorporated the proportion of bloodstream infections due to Escherichia coli resistant to third-generation cephalosporins and methicillin-resistant Staphylococcus aureus (MRSA) as two markers of national AMR status. Data from many of the SEA Region Member States show a persistent level of these two AMR markers between 2017 and 2020. More importantly, they show an increasing level of hospital-associated bloodstream infections. Other reports from Bangladesh, Nepal, and Sri Lanka indicate high levels of resistance to beta-lactam antibiotics. Meanwhile, data from India have shown increasing resistance among E. coliKlebsiella pneumoniae, and S. aureus.

The implementation of each nation’s NAPs in the SEA Region, supported by WHO, has varied widely between and within countries. In 2022, none of the Member States had provided cost estimates for NAP implementation, therefore preventing appropriate budget allocations for AMR containment at the state and national levels.

The next decade will be critical to the success of the implementation of NAPs against AMR in the WHO SEA Region. Strengthened surveillance capacity and adoption of the WHO AWaRe classification of antibiotics among the 11 Member States can help accelerate these countries’ response to AMR, and prioritizing One Health-centered policies will help them address AMR from a holistic standpoint.

Read the full article, published in The Lancet Regional Health – Southeast Asia, here.