Promoting sustainable national action to tackle antimicrobial resistance: a proposal to develop an antimicrobial resistance accountability index

Antimicrobial resistance (AMR) is a significant public health crisis, causing 1-14 million deaths worldwide in 2021. If not addressed, AMR could cost the global economy $412 billion annually due to increased healthcare costs and $443 billion annually due to lost workforce productivity. Despite progress, countries are inconsistent in implementing recommended policies, such as stewardship of antimicrobials, infection prevention, public awareness, and investment in research and development of novel antimicrobials and alternatives. Factors influencing global inconsistency include differences in resources, political commitment, healthcare infrastructure, and public health priorities. Additionally, many countries lack accountability mechanisms, leading to weak governance mechanisms and high AMR rates. Policymakers and academics are calling for a target-based approach to stimulate consistent implementation of AMR policies globally. The 2024 UN political declaration includes targets to achieve by 2030, including a 10% reduction in mortality from bacterial AMR, 70% reduction in access group antibiotics, and a funded AMR national action plan.