WHO releases Global AMU data to guide progress against AMR

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A major driver of AMR is the inappropriate use of antimicrobials. This is a common issue in many resource-limited countries with poor access to the correct medicines and treatment. To prevent antimicrobials from becoming ineffective against infections, antimicrobial use surveillance data is critical for guiding and monitoring antibiotic access and usage.

The Fleming Fund Technical Lead for Mott MacDonald, Dr Toby Leslie, shares his thoughts on the report's main findings and comments on the stark differences between countries laid bare by new global insights on antimicrobial use (AMU).

On 29 April, the World Health Organization (WHO) released a report on the usage of antimicrobials reported into the Global Antimicrobial Resistance and Use Surveillance System (GLASS). Partly funded by the Fleming Fund through UK Aid, the report is based on antimicrobial usage data from 60 countries during 2022 − a detailed snapshot of antibiotic use, according to the WHO classification system, ‘AWARE’.

The WHO AWARE system aims to preserve the most important antibiotics while providing access to treatments of common infections. Aware stands for:

• ‘Access’ – medicines that should be widely accessible.
• ‘Watch’– medicines that need monitoring and are used sparingly.
• ‘Reserve’ – medicines that should be saved only for the most severe cases of need, typically where all other drug treatment options have failed.

Monitoring antibiotic usage is important for several reasons:

• It allows an understanding of the average number of antibiotic doses per person annually.
• It helps monitor progress towards the 2030 target of 70% antibiotics from the Access category.
• It allows improved use of antibiotics for patient care.
• It reinforces regulation and, when viewed alongside data on drug resistance, it allows better policies and practices to reduce the problem of AMR.

One of the main findings is that overall, reporting from countries has improved. This means that surveillance at a global level is making considerable progress. Country enrollment and reporting data have increased, and it is encouraging to see how many Fleming Fund countries have enrolled and supplied data.

Although the report doesn’t identify individual countries, it has highlighted some stark differences between countries with differing income levels. Globally, 18 out of 1,000 people are taking antibiotics per day. The figure is much higher in lower-middle-income countries (27 out of 1,000 per day), where there is greater reliance on antibiotics and where markets are less well regulated; in low-income countries, the figure is much lower (9 out of 1,000 per day), reflecting less access to antibiotics.

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