Global Action Plan on Antimicrobial Resistance

The Global Action Plan on Antimicrobial Resistance (GAP-AMR) is the foundational international framework adopted in 2015 to guide global, national and multisectoral efforts against antimicrobial resistance (AMR). It was approved by the World Health Assembly in May 2015 and later endorsed by the Food and Agriculture Organization (FAO), the World Organisation for Animal Health (WOAH, formerly OIE), and welcomed by the United Nations Environment Programme (UNEP) — together forming a “Quadripartite” leadership in AMR response.
Its aim is to curb the emergence and spread of drug-resistant pathogens across humans, animals, food, agriculture, and the environment by promoting a One Health approach.

Background and Rationale

The rise of AMR constitutes a critical global health threat: pathogens increasingly evolve resistance to available antimicrobials, undermining the effectiveness of treatments, surgical interventions, and disease control. Recognising that AMR is driven by human health, animal health, agricultural use, and environmental contamination, the GAP-AMR provides a common blueprint for action across sectors.
By 2023, 178 countries had developed National Action Plans (NAPs) aligned with GAP-AMR, though only a subset had fully financed and operationalised them.

Core Strategic Objectives

The Global Action Plan centres on five strategic objectives, each addressing a dimension of the AMR challenge.

1. Improving awareness and understanding of AMR

This objective emphasises communication, education, training and behavioural change to increase knowledge of antimicrobial resistance among health professionals, veterinarians, farmers, policy makers and the public.

2. Strengthening knowledge through surveillance and research

Effective monitoring of antimicrobial use (AMU) and resistance patterns is essential. This includes establishing surveillance systems, standardising data collection, sharing results, and promoting research to fill knowledge gaps.

3. Reducing the incidence of infection

Preventing infections means fewer antimicrobial prescriptions. Measures include improved infection prevention and control (IPC) in healthcare, better water, sanitation and hygiene (WASH), vaccination, biosecurity in animal production, and safe food handling standards.

4. Optimising the use of antimicrobial agents

Rational prescribing, stewardship programmes, regulation of over-the-counter access, guidelines for animal use, and promoting alternatives (e.g. vaccines, diagnostics) are key to ensuring antimicrobials are used only when needed and in the right way.

5. Ensuring sustainable investment

The plan recognises that AMR initiatives require long-term funding. It calls for mobilising resources, making the economic case, incentivising research and development (R&D) of new antimicrobials, diagnostics, vaccines, and supporting access and affordability in low- and middle-income countries.

Implementation Framework and Monitoring

To support countries, WHO and its partners produced implementation guidelines, costing and budgeting tools, and monitoring & evaluation frameworks.

• The Monitoring & Evaluation of the Global Action Plan (M&E) document provides suggested indicators for each objective and a framework for national measurement and reporting.
• The Quadripartite’s “Implementing the Global Action Plan” reports provide biennial updates on progress, gaps, and emerging priorities.
• A Comprehensive Review mandated by WHA resolution WHA72.5 assessed successes, challenges, and lessons to guide future action.

Progress, Challenges and Critiques

Despite widespread adoption of NAPs, implementation has been uneven:

• In many regions (e.g. parts of Africa), overall GAP implementation is inadequate, with weak surveillance, funding, and coordination.
• Only a few countries have fully costed and budgeted NAPs; many struggle to allocate sufficient resources for execution.
• Political commitment and governance mechanisms at high levels are often lacking, reducing accountability.
• Global research and development for new antimicrobials and diagnostics remains underfunded; pipeline gaps persist.
• The COVID-19 pandemic disrupted AMU patterns and health priorities, complicating progress.

Critics argue that GAP’s broad framework is necessary but insufficient: what matters is actual resource mobilisation, political will, multisector coordination, and enforcement of policies.

Recent and Future Directions

In 2024, world leaders adopted a Political Declaration at the 79th UN General Assembly High-Level Meeting on AMR, committing to ambitious targets — including a 10 % reduction in AMR-attributable deaths by 2030.
They also mandated an update of the Global Action Plan by 2026 to better align with evolving challenges and accelerate impact.
Going forward, the emphasis is on:

• Strengthening One Health governance, integrating human, animal, and environmental sectors.
• Ensuring sustainable financing and innovative incentives for R&D (push and pull mechanisms).
• Enhancing surveillance capacity and data sharing, especially in low-resource settings.
• Promoting behavioural change for antibiotic use, waste management, and hygiene.
• Embedding AMR action into national development plans, health systems, agriculture policies, and environmental regulation.

The Global Action Plan on AMR remains the central tool for aligning global efforts, and its success hinges on translating strategic objectives into real, sustained action across countries and sectors.