Mathatisi Sebusi
THE World Health Organization (WHO) has issued a stark warning about the growing threat of antibiotic resistance, revealing that many commonly used antibiotics are becoming ineffective against major infections.
In its Global Antibiotic Resistance Surveillance Report 2025, set for official release tomorrow, WHO reports that 22 widely used antibiotics are showing increasing resistance in treating urinary tract, bloodstream, gastrointestinal infections and gonorrhoea.
The report reveals that one in six laboratory-confirmed bacterial infections worldwide in 2023 were resistant to antibiotic treatment. Between 2018 and 2023, resistance increased in over 40% of the antibiotics tracked, with annual growth rates ranging from 5% to 15%.
The data, collected through WHO’s Global Antimicrobial Resistance and Use Surveillance System (GLASS) from more than 100 countries, signals a growing global health crisis. The 2025 report provides, for the first time, resistance estimates across 22 antibiotics used to treat infections caused by eight common bacterial pathogens, including Acinetobacter spp., Escherichia coli, Klebsiella pneumoniae, Neisseria gonorrhoeae, nontyphoidal Salmonella spp., Shigella spp., Staphylococcus aureus, and Streptococcus pneumoniae.
Regional Disparities
The report highlights sharp regional differences in resistance levels. The WHO South-East Asia and Eastern Mediterranean Regions had the highest rates, with one in three infections resistant to antibiotics. In the African Region, one in five infections was resistant. The burden is particularly high in areas with weak health systems that lack diagnostic and treatment capabilities.
During the launch of the report on Thursday, WHO Director-General Dr Tedros Adhanom Ghebreyesus said:
“Antimicrobial resistance is outpacing advances in modern medicine, threatening the health of families worldwide.”
He stressed the urgent need for responsible antibiotic use, access to quality medicines and diagnostics, and innovation in treatment and testing technologies.
Rise of drug-resistant bacteria
The report draws particular attention to the rise of drug-resistant Gram-negative bacteria, especially E. coli and K. pneumoniae, which are major causes of bloodstream infections that often lead to sepsis, organ failure, and death.
Globally, over 40% of E. coli and 55% of K. pneumoniae infections are now resistant to third-generation cephalosporins—the first-line treatment—and in the African Region, resistance rates even exceed 70%. Resistance is also increasing to carbapenems and fluoroquinolones, two essential antibiotic classes, further limiting treatment options.
“Carbapenem resistance, once rare, is now rising steadily, forcing reliance on last-resort drugs. These are often costly, hard to access, and largely unavailable in low- and middle-income countries,” said Dr Ghebreyesus.
A Call to Strengthen Surveillance and Action
The report underscores that antimicrobial resistance (AMR) remains one of the most urgent global health threats, undermining treatment effectiveness and putting millions at risk.
To tackle this, WHO launched GLASS in 2015. Country participation has grown from 25 countries in 2016 to 104 in 2023. However, 48% of countries did not submit data in 2023, and nearly half of the reporting nations lack systems capable of generating reliable data.
The 2024 United Nations General Assembly adopted a political declaration on AMR, calling for stronger health systems and a One Health approach—addressing human, animal, and environmental health together.
Dr Ghebreyesus emphasized the need for countries to strengthen laboratory and surveillance systems, especially in underserved areas:
“Countries must report high-quality AMR and antibiotic use data to GLASS by 2030.”
Way forward
To effectively combat AMR, WHO urges countries to scale up surveillance and data sharing, align treatment guidelines with local resistance patterns, ensure access to quality diagnostics and antibiotics, and invest in next-generation antibiotics and rapid diagnostic tools.
“Only through global collaboration, improved access to essential healthcare tools, and innovation can we overcome the growing challenge of antimicrobial resistance,” WHO concluded.
Speaking with the Sunday Express, Ministry of Health Pharmacist and AMR National Focal Point, Nteboheng Tjobe-Maina, said antimicrobial resistance is a silent threat to Lesotho’s health and future:
“In 2019, over 2,800 deaths in Lesotho were linked to antimicrobial resistance (AMR)—more than deaths from cancer, diabetes, or even maternal conditions. Lesotho now ranks among the top 10 countries globally with the highest AMR-related death rates.”
She explained that AMR occurs when medicines like antibiotics, antivirals, antifungals, or antiparasitics stop working against the germs they are meant to kill:
“This makes infections like tuberculosis, pneumonia, and wound infections harder to treat, leading to longer illness, higher costs, and more deaths. Taking antimicrobials without a prescription or not finishing the full dose allows microorganisms to survive and become stronger.”
Ms Tjobe-Maina warned that improper use of antimicrobials in animals and consumption of animal products without respecting withdrawal periods can pass resistant bacteria to humans.
She also highlighted risks from street vendors, unlicensed pharmacies, and environmental pollution from antimicrobial waste.
Ms Tjobe-Maina urged Basotho to take antimicrobials only when prescribed by qualified health workers, complete the full course, avoid sharing or reusing leftover medicines, practice good hygiene, ensure children receive all scheduled vaccinations, and for farmers and animal owners to use antimicrobials only under veterinary guidance. She further emphasized respecting withdrawal periods, improving biosecurity, and vaccinating animals and pets to reduce disease outbreaks and the need for antimicrobial treatment.
She also called on the public to stop dumping expired medicines into water or soil and instead dispose of them safely by returning them to health facilities, Village Health Workers, or agricultural officers.
Ms Tjobe-Maina noted that Lesotho has a National Multisectoral Action Plan (2021–2026) aimed at combating AMR across health, agriculture, and environmental sectors.