A Call for Behavioural and One Health-Based Action for Anti-microbial Resistance in Pakistan

Abstract

Antimicrobial resistance (AMR), a silent pandemic, is a growing public health challenge in Pakistan. In a country where the healthcare system is already constrained and public hospitals have limited capacity to meet patient needs. AMR is turning previously treatable diseases into significant causes of morbidity and mortality. By reducing the effectiveness of available treatments, AMR not only worsens health outcomes but also increases healthcare costs for both individuals and the system as a whole.

In 2017, Pakistan’s National Action Plan (NAP) on AMR, aligned with the World Health Organization’s Global Action Plan was launched (1). Among 204 countries, Pakistan remains among countries with a high burden of AMR, ranking 53rd globally for age-standardised mortality associated with anti-microbial resistance in 2021 (2).

AMR awareness weeks are regularly observed, and the major drivers of resistance such as over-the-counter antibiotic sales, inappropriate prescribing, and incomplete antibiotic treatment courses are well recognised. However, resistance continues to rise. Pakistan is third largest consumers of antibiotics among LMIC’s (3). Antibiotic misuse is often attributed to poor public knowledge. For many individuals, prolonged illness threatens daily income, and economic stability. This pushes people toward private or informal providers or self-medication. In such circumstances, seeking rapid symptom relief becomes a rational response rather than careless behaviour.