Potential for improvement in governance and national action plans to overcome antimicrobial resistance

With more than 1·2 million deaths directly attributable to infections with resistant bacteria in 2019, the constantly increasing burden of antimicrobial resistance is a leading cause of death, disability, and economic loss in every region and country globally. Antimicrobials are a global public good that need protection from a “tragedy of the commons”. Protecting people from overuse of antibiotics, misuse of antibiotics, and infections, particularly infections with resistant bacteria, requires both global action and nationally targeted responses. However, antimicrobial resistance is a complex multisectoral and multifactorial process. Interventions should be coordinated via overarching plans that are sustained by robust governance frameworks. For example, member countries of WHO endorsed the Global Action Plan (GAP) on antimicrobial resistance in 2015, which explicitly requests countries develop national action plans (NAPs), identify priorities, allocate resources for NAP implementation, and establish national and local governance arrangements.