AMR data
ANTIMICROBIAL resistance is a multifaceted growing global health threat. To counter it, the WHO has launched a number of initiatives over the last decade, one of which involves the setting up of a Global Antimicrobial Resistance and Use Surveillance System to generate and strengthen evidence on AMR via data collection and analysis. Since 2016, a growing number of member states have enrolled in the system and reported data to GLASS.
The data is consolidated into an annualised GLASS report. Its latest edition came out recently. The 2025 report is based on 23 million bacteriologically confirmed infections reported by 104 countries. The report monitors the eight most common bacterial pathogens responsible for bloodstream, gastrointestinal, urinary tract and urogenital gonorrhoea infections. The report generates estimates for regional, global and national AMR levels to help evidence-based policy formulation. Besides generating estimates, the report assesses the state of national AMR surveillance coverage in terms of incremental improvement or regression.
It finds that resistance to essential antibiotics is increasing and is mal-distributed region-wise with low- and middle-income counties showing higher levels of resistance. This is linked to weak AMR surveillance systems and limited laboratory capacity. In particular, the effectiveness of first-line antibiotics, included in the WHO Access category, is decreasing, especially in LMICs. In terms of data reporting to the GLASS, the 2025 report represents considerable improvement, with 104 countries sharing surveillance data, a four-fold increase since 2016.
Despite this progress, regional disparities in AMR data-sharing and reporting in terms of participation are glaring. For example, participation from the Regions of the America was the lowest with seven out of 35 countries reporting to the GLASS while participation from the East Asian region was the highest with 10 out of 11 countries sharing AMR data. In the Eastern Mediterranean Region, of which Pakistan is a part, 16 out of 21 countries shared AMR surveillance data. Participation by the European and African regions was slightly above 50 per cent, meaning over half of the member states participated in the data reporting exercise. The GLASS report shows that countries with weak AMR surveillance systems show higher levels of AMR, which is largely the case with LMICs.
Resistance to essential antibiotics is increasing.
The report makes some recommendations such as increasing antibiotic use from the Access group to 70pc of human use, expanding laboratory capacity, strengthening antimicrobial stewardship, and equitable access to antibiotics. The importance of a robust AMR surveillance system embedded in the AMR national action plans is key to achieving these policy goals.
Pakistan, too, has contributed to the report data. AMR surveillance data submitted is assessed for its completeness and quality in about four domains — implementation levels of national AMR surveillance systems, expansion of nationally representative surveillance coverage, collection of robust data for four GLASS-monitored infections and harmonising laboratory data with epidemiological, demographic and clinical information.
As the report shows, the quality and completeness of data in relation to national coverage of especially GLASS data on health infrastructure and data on inpatients and outpatients requires improvement in Pakistan. However, data on infections types and epidemiological and clinical and demographic information is judged complete.
The area where data is incomplete or not available does not reflect well on the functioning of the AMR surveillance systems that should have matured by now. The previous AMR national action was patchy in implementation showing progress in some areas while falling short in many others.
The revised AMR national action, an improvement on the previous plan, has yet to see the light of day. However, AMR surveillance and the AMR national action plan can only cohere if sufficient local funding is made available backed by strong political commitment.
More importantly, a donor-funded push to put in place the national AMR infrastructure and action plan can only go some way. In the long term, only sustained local funding and getting AMR data collection into the health department — from district levels upwards — can turn the tide. The decreased overall funding for health and public sector in the last budget coupled with IMF-driven public spending cuts and the continuous hike in military expenditure do not inspire much confidence.
The writer is a public health consultant and author of Patient Pakistan: Reforming and Fixing Healthcare for All in the 21st Century.
X: @arifazad5
Published in Dawn, December 11th, 2025