It’s possible that I shall make an ass of myself. But in that case one can always get out of it with a little dialectic. I have, of course, so worded my proposition as to be right either way (K.Marx, Letter to F.Engels on the Indian Mutiny)
Friday, May 02, 2025
Every action counts: Global study shows countries can reverse increasing antibiotic resistance
A new study, led by Peter Søgaard Jørgensen from the Stockholm Resilience Centre at Stockholm University, reveals that while global cooperation remains essential, countries have more power than previously believed to reduce antibiotic resistance through effective domestic interventions. Currently only a handful of countries are taking sufficient action.
The study is the first to assess the level of government intervention needed to improve the worsening situation on antibiotic resistance across 73 countries. The researchers find strong associations between the level of action a country reports and whether antibiotic use and antibiotic resistance increased during a 16-year period in the start of the 21st century.
Measures that curb resistance
A wide set of measures like monitoring antibiotic use, improving hospital hygiene, coordinating action across human health and livestock production, and investing in new treatment strategies are all likely to be needed to curb resistance at the national level.
“Too often, we hear that antibiotic resistance is an inevitable catastrophe beyond our control,” says Jørgensen. “But our study tells a different story—one of hope and agency. If countries act decisively, they can still make a difference,” continues Peter Søgaard Jørgensen.
Countries leading the way
The study shows that a handful of countries are leading the way, taking the necessary level of action to have a better than even chance to see reductions in resistance across the board. In 2016 those countries were the Netherlands, Norway, Sweden and UK. Six years later, in 2023, Japan, France, Malaysia and Denmark, have become the countries that are taking the most extensive actions.
“A positive trend is that between 2016 and 2023, 76% of all analysed countries, and 83% of low- and middle-income countries, were reporting to ramp up their actions,” says Peter Søgaard Jørgensen.
Every action counts
Although the findings indicate that high levels of action are needed to achieve reductions in antibiotic resistance, the research also finds that even incremental increases in action can be important. For every improvement in action, the magnitude of increases in resistance goes down and countries get closer to achieving a reduction in levels of resistance.
“The study’s findings send a clear message to policymakers: the time to act is now. By taking evidence-based steps, governments can protect their own citizens while also contributing to the global fight against resistant infections,” says Peter Søgaard Jørgensen.
Peter Søgaard Jørgensen is a senior researcher at Stockholm Resilience Centre, Stockholm University, and the Deputy Executive Director of the Global Economic Dynamics and the Biosphere programme (GEDB) at the Royal Swedish Academy of Sciences.
This study is a collaboration between leading institutions such as OneHealthTrust, Johns Hopkins University, Cornell University, University of Geneva, the Stockholm Resilience Centre, and the GEDB programme at the Royal Swedish Academy of Sciences.
The study in a nutshell:
The study compared self-reported levels of action among 73 countries with changes in antibiotic resistance and use during the period 2000 to 2016. The scientists then looked at how levels of action had changed from 2016 to 2023 to see if the same countries were still taking the same level of action. Additional research is needed to evaluate the effects of action levels in 2023.
Levels of action on antibiotic resistance in 73 countries investigated in the study. An action index close to 3.7 is needed to have a better than an even chance of reducing antibiotic resistance across the board.
Levels of action on antibiotic resistance in 73 countries investigated in the study. An action index close to 3.7 is needed to have a better than an even chance of reducing antibiotic resistance across the board.
National-level policies can reduce the impact of antibiotic resistance across diverse countries, according to a study published April 30, 2025 in the open-access journal PLOS Global Public Health by Peter Søgaard Jørgensen from Stockholm University and the Royal Swedish Academy of Sciences, Sweden, and colleagues.
Antibiotic resistance is a major public health concern, contributing to 1.27 million deaths per year. In 2016, countries around the world committed to developing and implementing national action plans to combat antibiotic resistance. These plans have been criticized for not being fully operationalized. Assessing their impact is challenging—change doesn’t happen overnight, not all countries report their data systematically, and the COVID-19 pandemic disrupted monitoring.
In this study, researchers used the Global Database for Tracking Antimicrobial Resistance Country Self- Assessment Survey (TrACSS) and data on antibiotic use and antibiotic resistance to evaluate the impact of national action over time in 73 countries, representing six continents across high and low-middle income countries. They looked at national trends in indicators related to antibiotic resistance, including antibiotic use, rates of antibiotic resistance, and impact of resistant infections.
By assigning each country an action index, they found that national action was consistently associated with improved indicators of antibiotic resistance. These associations persisted after controlling for factors like socioeconomic conditions, population density, and climate.
Since 2016, both high and low-middle income countries have become more ambitious with their national action plans; only one-third have decreased their efforts to reduce antibiotic resistance.
The authors noted some bias in their sample size in that high-income countries are more likely to have established monitoring systems but stressed the importance of studies like this to establishing the impact of national policies on tackling antibiotic resistance.
The authors add: “Our research shows the importance of all countries taking additional action to address antibiotic resistance. Very ambitious action will be needed to achieve reductions in resistance, but even incremental improvements will help reduce the projected increases…We were not sure that it would be possible to reduce levels of antibiotic resistance while also keeping using antibiotics to the extent that is required by modern health systems, but our research indicates that it is indeed possible.”
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In your coverage please use this URL to provide access to the freely available article in PLOS Global Public Health: https://plos.io/3Gv8DR4
Citation: Søgaard Jørgensen P, Thanh LN, Pehlivanoğlu E, Klein F, Wernli D, Jasovsky D, et al. (2025) Association between national action and trends in antibiotic resistance: an analysis of 73 countries from 2000 to 2023. PLOS Glob Public Health 5(4): e0004127. https://doi.org/10.1371/journal.pgph.0004127
Author Countries: Sweden, Switzerland, United States
Funding: We acknowledge funding from the Erling-Persson Family Foundation (P.S.J., L.N.T., E.P., F.K.), the European Union (ERC, INFLUX, 101039376, P.S.J.), the IKEA Foundation (P.S.J.), the Marianne and Marcus Wallenberg Foundation (P.S.J) and the Uppsala Antibiotic Centre (UAC, L.N.T.). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Views and opinions expressed are, however, those of the author(s) only and do not necessarily reflect those of the European Union or the European Research Council. Neither the European Union nor the granting authorities can be held responsible for them. We thank SESYNC for support for the Living with Resistance pursuit, which this paper is a product of.
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