Antimicrobial Resistance As A Global Public Health Challenge: Mechanisms, Drivers, Surveillance And Integrated Control Strategies

Abstract

Antimicrobial resistance (AMR) is a rapidly intensifying public health problem that compromises the treatment of common infections, raises the risk of complications after surgery and other medical interventions, and increases health-care costs. This narrative review synthesizes current evidence on the biological mechanisms, major human and system-level drivers, clinical and socioeconomic consequences, surveillance approaches, and priority interventions for AMR control. Peer-reviewed literature and authoritative reports from the World Health Organization (WHO), the Centers for Disease Control and Prevention, the European Centre for Disease Prevention and Control, and other international sources were considered, with emphasis on evidence published from 2000 to 2026. Resistance emerges through chromosomal mutation and acquisition of mobile genetic elements and is amplified by inappropriate antimicrobial exposure, inadequate infection prevention and control, delayed microbiological diagnosis, and antimicrobial use across human, animal, food and environmental sectors. Recent WHO surveillance indicates that approximately one in six laboratory-confirmed bacterial infections worldwide was resistant to antibiotics in 2023, while bacterial AMR was associated with more than 4.7 million deaths in 2021. Effective containment therefore requires an integrated One Health response combining antimicrobial stewardship, rapid and quality-assured diagnostics, infection prevention and control, vaccination, surveillance, responsible antimicrobial use in agriculture and veterinary practice, public education, and sustained research and development. Strengthening national surveillance and linking resistance data with antimicrobial consumption are particularly important for translating global recommendations into locally effective public health action