As the global healthcare community marks World AMR Awareness Week 2025, the message is clear: “Act Now: Protect Our Present, Secure Our Future.” Antibiotics have saved millions of lives, revolutionized modern medicine, and made complex procedures like organ transplantation, chemotherapy, intensive care, and major surgery possible. Yet this medical progress is now at risk. With antimicrobial resistance (AMR) rising rapidly worldwide, antibiotics are losing their effectiveness faster than anticipated, threatening treatment options, increasing mortality, and placing immense pressure on health systems.
Understanding the Global AMR Crisis
Antimicrobial resistance occurs when bacteria, viruses, fungi, and parasites evolve to resist the medications designed to eliminate them. What was once a treatable infection can become a life-threatening condition when the antimicrobial arsenal fails. The World Health Organization has declared AMR one of the top ten global public health threats, with projections indicating substantial increases in AMR-related deaths if current trends continue.
The numbers paint a sobering picture. In 2019, bacterial AMR was directly responsible for approximately 1.27 million deaths and associated with 4.95 million deaths globally. More recent analysis forecasts that AMR could directly cause 1.91 million deaths annually by 2050, representing a 67.5% increase from 2021 levels. These figures transcend borders, affecting both high-income and low-resource settings, though vulnerable populations bear a disproportionate burden.
The Importance of Pharmacovigilance in AMR Control
Pharmacovigilance (PV) occupies a unique vantage point in the fight against AMR. The discipline extends far beyond traditional adverse event monitoring; it acts as a sentinel system for detecting early signals of resistance patterns, a guardian of antimicrobial stewardship, and a framework for ensuring rational drug use across human, animal, and environmental health sectors.
Signal Detection and Resistance Surveillance
Pharmacovigilance systems serve as essential early warning networks for emerging resistance patterns. Through rigorous monitoring of antimicrobial efficacy reports, treatment failures, and resistance-related adverse events, these systems can identify trends before they escalate into full-blown public health crises.
Every case of antimicrobial ineffectiveness reported through safety channels provides crucial intelligence that informs prescribing guidelines, resistance surveillance programs, and public health interventions. When healthcare providers report unexpected treatment failures or prolonged infections despite appropriate antimicrobial therapy, these signals must be investigated, documented, and communicated to regulatory authorities and the broader medical community. Pharmacovigilance databases contain invaluable real-world evidence that complements laboratory surveillance, offering insights into how resistance manifests in clinical practice.
Promoting Antimicrobial Stewardship
Antimicrobial stewardship, the systematic effort to optimize antimicrobial use, relies heavily on data derived from pharmacovigilance. Safety monitoring activities directly support stewardship programs by:
- Providing evidence-based guidance on appropriate antimicrobial selection and duration.
- Identifying prescribing patterns that may contribute to resistance development.
- Documenting outcomes associated with antimicrobial de-escalation strategies.
- Supporting the development of treatment algorithms that balance efficacy with resistance prevention.
Through this data, healthcare institutions can implement protocols ensuring patients receive the right drug, at the right dose, for the right duration, and only when truly necessary. This precision approach minimizes unnecessary antimicrobial exposure that drives resistance while maintaining optimal patient outcomes.
The One Health Connection
AMR recognizes no boundaries between human medicine, veterinary practice, and environmental health. This year's World AMR Awareness Week emphasizes the "One Health" approach, acknowledging that antimicrobial use in agriculture, aquaculture, and companion animals significantly impacts human health.
Pharmacovigilance must expand its traditional scope to encompass this interconnected reality. Integrated surveillance systems are required to track antimicrobial use and resistance across all sectors. When veterinary antimicrobials enter the food chain or agricultural runoff contaminates water supplies, resistant organisms can transfer to human populations through multiple pathways. Modern monitoring systems must be sophisticated enough to detect these complex transmission dynamics.
Furthermore, the pharmaceutical manufacturing process itself can contribute to environmental AMR when antimicrobial-laden wastewater from production facilities creates selective pressure for resistance in environmental bacteria. Pharmacovigilance frameworks should incorporate environmental impact assessments and manufacturing standards to prevent such contamination.
Strategic Pillars for Pharmacovigilance Systems
To effectively combat AMR, pharmacovigilance frameworks must adopt the following actionable strategies:
Enhance Reporting Culture
A robust PV system relies on the active reporting of not just traditional adverse events, but also treatment failures, prolonged courses, and suspicions of resistance. Creating user-friendly reporting mechanisms specifically for AMR-related concerns is essential. Every piece of information contributes to the larger picture of resistance patterns.
Leverage Real-World Data
Electronic health records, prescription databases, and laboratory results should be harnessed to conduct proactive surveillance. Advanced analytics and artificial intelligence can identify resistance signals earlier and more accurately than passive reporting alone. Integrating resistance data directly into pharmacovigilance workflows—bridging the gap with clinical microbiology—is a critical step forward.
Support Diagnostic Stewardship
Rapid and accurate diagnostics are essential for appropriate antimicrobial selection. Pharmacovigilance advocates for the widespread implementation of rapid diagnostic tests that identify pathogens and resistance profiles quickly, enabling targeted therapy instead of empiric broad-spectrum coverage. Documenting outcomes associated with diagnostic stewardship builds the evidence base for these interventions.
Foster Interdisciplinary Collaboration
Silos must be broken down between pharmacovigilance, infectious disease specialists, clinical pharmacists, veterinarians, environmental scientists, and public health officials. Platforms for regular communication and data sharing are vital, as AMR is too complex for any single discipline to address alone.
Educate and Advocate
Pharmacovigilance data should be used to educate prescribers, patients, and policymakers. Translating complex resistance data into actionable clinical guidance supports policies that promote antimicrobial stewardship, infection prevention, and research into novel antimicrobials and alternatives.
Innovation and Future Directions
The fight against AMR requires innovation in scientific approaches and pharmacovigilance methodologies. Emerging technologies offer promising tools:
- Machine learning algorithms can predict resistance emergence based on prescribing patterns and patient characteristics.
- Blockchain technology could create transparent, secure systems for tracking antimicrobial use across global supply chains.
- Pharmacogenomic insights may enable personalized antimicrobial dosing that maximizes efficacy while minimizing resistance selection.
- Novel biomarkers could distinguish bacterial from viral infections, reducing unnecessary antimicrobial prescriptions.
Pharmacovigilance systems must evolve to incorporate these innovations while maintaining robust safety monitoring.
A Call to Action
World AMR Awareness Week 2025 presents an opportunity for the pharmacovigilance sector to recommit to this critical mission. The theme "Act Now: Protect Our Present, Secure Our Future" is not merely aspirational; it is an urgent directive that demands immediate, sustained action, building on momentum from the 2024 UN High-Level Meeting on AMR.
Action is required now because resistant infections are claiming lives today, lengthening hospital stays, increasing healthcare costs, and limiting treatment options for common infections and life-saving procedures. Economic analyses suggest that AMR could result in at least USD 3.4 trillion in annual GDP losses by 2030 if left unaddressed.
The present must be protected by implementing evidence-based antimicrobial stewardship programs, strengthening pharmacovigilance systems, and ensuring equitable access to quality antimicrobials and diagnostics globally.
The future must be secured by investing in antimicrobial research and development, building surveillance infrastructure that spans the One Health continuum, and fostering international cooperation on this shared threat.
Moving Forward
Pharmacovigilance provides the knowledge, tools, and structural responsibility necessary to make meaningful contributions to the global AMR response. The commitment must be to enhanced vigilance, improved reporting, interdisciplinary collaboration, and unwavering advocacy for antimicrobial stewardship.
The future of antimicrobial effectiveness, and indeed, modern medicine, depends on the actions taken today. Pharmacovigilance work is not just about monitoring drug safety; it is about preserving humanity's ability to treat infections effectively for generations to come.
Let this World AMR Awareness Week mark not just increased awareness, but concrete action. Through systemic improvements, the curve on resistance can be bent, protecting existing antimicrobials and ensuring that when new infections emerge, effective tools remain available to combat them.
Act now. The time for incremental change has passed. The future of healthcare depends on the decisions and actions taken today.
References
- World Health Organization. (2025). World AMR Awareness Week 2025. Available at: https://www.who.int/campaigns/world-amr-awareness-week/2025
- World Health Organization. (2025, November 17). World AMR Awareness Week 2025 urges action to turn political commitments into life-saving interventions. Available at: https://www.who.int/news/item/17-11-2025-world-amr-awareness-week-2025-urges-action-to-turn-political-commitments-into-life-saving-interventions
- Antimicrobial Resistance Collaborators. (2022). Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. The Lancet, 399(10325), 629-655. doi: 10.1016/S0140-6736(21)02724-0
- Naghavi, M., Vollset, S. E., Ikuta, K. S., et al. (2024). Global burden of bacterial antimicrobial resistance 1990-2021: a systematic analysis with forecasts to 2050. The Lancet, 404(10459), 1199-1226. doi: 10.1016/S0140-6736(24)01867-1
- World Health Organization. (2023). Antimicrobial resistance. WHO Fact Sheets. Available at: https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance