Antimicrobial resistance (AMR) is a critical global health threat that undermines the safety of routine medical procedures and reverses many advances in modern medicine by rendering antimicrobials ineffective against infections. Inappropriate use of antimicrobials is a major driver of AMR; at the same time, inadequate access to essential, quality-assured medicines remains a problem in many resource-limited settings.
National and global surveillance data on antimicrobial use (AMU) guide stewardship and monitoring of progress towards better access to and use of antibiotics. To accelerate this work, global leaders approved a political declaration at the 79th United Nations General Assembly High-level Meeting on AMR, which committed them to a clear set of targets and actions. These include ensuring that 70% of antibiotics used globally are in the WHO AWaRe (Access, Watch, Reserve) Access group and building national surveillance systems to report high-quality data on AMU to the Global Antimicrobial Resistance and Use Surveillance System (GLASS) by 2030.
This report describes progress in the participation of countries, territories and areas (CTAs) in GLASS-AMU by the end of 2023. Since the launch of the national AMU surveillance component of GLASS in 2020, participation has increased; 90 countries and territories were enrolled by the end of 2023, and 74 report national data over the years. The report also shows, however, that global participation remains below 50%, with important gaps due to non-participation of non-European and lower-income countries. WHO is committed to continuing to consolidating and extending GLASS in the coming years with support from Member States, WHO regional and country offices, regional networks, WHO collaborating centres and other international partners.
This GLASS report, produced in collaboration with Member States, summarizes estimates of AMU in 2022 and interpretation of the data according to the WHO AWaRe framework, the system developed by WHO to guide preparation of national and institutional lists of essential medicines and treatment guidelines, to meet priority health-care needs while optimizing antibiotic use for common infections.
Analysis of the data demonstrates considerable variation in antibiotic use by region and income level, indicating both areas of concern and opportunities for improvement. Disproportionate use of Watch antibiotics and underutilization of recommended Access first-line treatments indicates that targeted antibiotic stewardship is required. Better data analysis, interpretation and use and additional national targets for antibiotic use according to population health requirements are among WHO’s priorities for the near future. The WHO AWaRe antibiotic book will be useful by providing a template for developing or adapting national antibiotic guidance for prescribers.
With ongoing support from WHO and international partners, countries can strengthen their AMU surveillance systems and use the evidence generated to effectively improve the quality of patient care and combat AMR.