Rising Superbugs Could Undo Decades of Medicine, WHO Warns South-East Asia

The WHO’s 2025–2030 roadmap warns that antimicrobial resistance is a mounting crisis in South-East Asia, already causing nearly 400,000 direct deaths annually. It urges urgent political commitment, stronger health systems, and coordinated One Health action to prevent millions of future deaths.

Antimicrobial resistance (AMR) is increasingly described as a silent pandemic, and the World Health Organization’s Regional Office for South-East Asia has issued a stark new roadmap covering the years 2025 to 2030. The report warns that AMR is eroding the effectiveness of medicines that once revolutionized healthcare, threatening to return societies to a pre-antibiotic era where routine infections and common medical procedures carry grave risks. In the South-East Asia Region, the human cost is already immense. In 2019 alone, more than 392,000 deaths were directly attributed to drug-resistant bacterial infections, while a staggering 1.4 million deaths were associated with AMR overall. The Institute for Health Metrics and Evaluation, which contributed data to the roadmap, shows that in some countries of the region AMR now kills more people than diabetes, respiratory infections, tuberculosis, or maternal and neonatal disorders combined. Without urgent measures, experts caution that the trajectory points towards millions of preventable deaths and devastating economic consequences by mid-century.

A Threat to Development and the SDGs

The WHO roadmap positions AMR not just as a health emergency but as a profound development crisis. It directly undermines progress on infectious disease control, weakens food and nutrition security, jeopardizes safe childbirth and surgery, and threatens the achievement of the United Nations Sustainable Development Goals. Resistance develops when bacteria adapt to survive exposure to antimicrobial drugs, and the drivers of this trend are manifold. Overuse and misuse of antibiotics in humans remain widespread, with prescriptions often written unnecessarily for viral illnesses such as colds and influenza. In livestock and aquaculture, antibiotics are deployed extensively to prevent disease and boost yields, further accelerating the spread of resistant organisms. Weak regulations, poorly enforced drug sales laws, insufficient infection prevention and control measures in hospitals, and limited public awareness compound the problem. Meanwhile, innovation in the field has slowed to a near standstill. No new class of antibiotics has been discovered since 1987, and the handful of candidates in the pipeline are unlikely to offset the mounting crisis. Access to the medicines that do exist remains uneven, particularly in low- and middle-income countries where shortages of quality-assured drugs and diagnostics continue to fuel resistance.

National Plans, Patchy Progress

South-East Asia has not been idle. Since 2011, when AMR was declared a priority on World Health Day, countries in the region have drawn up national action plans with support from the WHO. All eleven member states now have such plans, and eight have already updated them to a “NAP 2.0” format. Yet progress on implementation is inconsistent. Only two countries have formally allocated budget lines for AMR within their national health plans, and the degree of integration across sectors remains weak. Despite commitments to the One Health approach, which brings together human, animal, and environmental health, most activities are siloed. Laboratories remain under-resourced, private healthcare providers are poorly engaged, and surveillance networks are patchy. The WHO’s own assessments confirm that although awareness has grown, the majority of plans are still only partially operational.

A People-Centred Roadmap Forward

The new roadmap aims to break this cycle of uneven implementation by urging governments to adopt a people-centred approach. This concept goes beyond technical measures and stresses the need to integrate AMR interventions into broader health system strengthening. Primary health care, universal health coverage, and pandemic preparedness are identified as crucial entry points. The strategy is structured around three major steps: first, an analysis of gaps in national action plan execution; second, evidence-based decision-making to prioritize corrective measures; and third, the creation of simple monitoring frameworks to track progress and adjust policies as needed. Underpinning these steps is a package of interventions ranging from stronger governance, awareness campaigns, and surveillance systems to the promotion of infection prevention, expanded vaccination, improved laboratory services, and better regulation of antibiotic sales.

Targets for 2030 are clearly spelled out. All countries in the region are expected to update and cost their national plans, with at least 60 percent committing domestic financing. Every member state should be reporting full surveillance data to WHO’s Global Antimicrobial Resistance and Use Surveillance System. All health facilities are expected to have basic water, sanitation, and hygiene services, while 90 percent should meet international infection prevention standards. The goal is for 80 percent of countries to develop the laboratory capacity needed to test for bacterial and fungal resistance, reducing delays in diagnosis and guiding rational use of medicines. By achieving these milestones, WHO estimates that as many as 92 million deaths could be averted globally between 2025 and 2050 through better care and known scientific strategies.

The Urgent Call for Political Will

The report underscores that responsibility lies foremost with national governments, but it also stresses the role of international collaboration. The Antimicrobial Resistance Multi-Partner Trust Fund, managed by the United Nations Development Programme, is cited as a key mechanism for financing. Major donors such as the European Union, the United Kingdom, Sweden, and Germany are already supporting pooled resources to accelerate AMR containment. Regional cooperation is also vital, with platforms like ASEAN, the G20, and the G7 repeatedly highlighting AMR as a political and economic priority. The World Health Assembly’s Resolution WHA77.6, adopted in 2024, commits member states to strengthening prevention, diagnosis, and treatment while investing in innovation and governance. Ultimately, the roadmap carries a stark warning. If antimicrobial resistance continues unchecked, it could reverse decades of progress in medicine, cripple economies, and cost millions of lives in South-East Asia alone. But it also offers hope: with stronger political commitment, targeted financing, and effective integration of AMR measures into health systems, the tide can be turned. The WHO pledges to provide technical support, but it is the resolve of governments, communities, and health professionals across the region that will determine whether South-East Asia can avert the worst outcomes of this silent but deadly pandemic.