Antimicrobial resistance (AMR) is one of the most pressing global public health threats today. As microorganisms evolve and no longer respond to available treatments, the options for managing and preventing severe infections become limited. This not only increases the risk of complications, hospital admissions, and death but also threatens advances in medical care. Recent outbreaks and pandemics have further underscored the far-reaching consequences of infectious diseases without effective treatment, raising critical questions about preparedness and global coordinated action.

To address these challenges, the World Health Organization (WHO) has systematically provided guidance and tools to support countries in combating AMR. Such efforts include global targets, stewardship protocols, and parameters for national action plans (NAPs). However, current trends in antibiotic use and the rising deaths attributed to bacterial resistance, estimated at 4.95 million in 2019, suggest the need for different approaches.

This white paper discusses the development of national antibiotic assessment reports (NAARs) as foundations for designing national antibiotic policies. By using a single standard method to combine multiple antibiotic use datasets within these reports, information can be made comparable within and across countries. Therefore, creating a more comprehensive assessment of antibiotic use, factoring in population health factors, could increase national ownership and improve the AMR response.

The paper is divided into three parts:

1. Understanding antibiotic use in humans: This section discusses global trends in antibiotic use over the last decade, reflects on current efforts and challenges to develop new anti-infectives, and highlights the barriers to collecting and processing the right data on AMR. An analysis of IQVIA data covering pharmacy sales in 87 countries from 2013 to 2023 shows an increase in antibiotic use worldwide, with noticeable variations across regions. The antibiotics selected for review are representative of the Access, Watch, and Reserve (AWaRe) groups, a WHO classification set in 2017 to support surveillance and ensure appropriate use and long-term stewardship.
2. The need for standardized NAARs: This section delves into the need for detailed antibiotic use assessments, including metrics to better inform national antibiotic policies and monitor progress. It presents an analysis of gaps in current NAPs and emphasizes the importance of comprehensive data collection and responsible antibiotic use. The paper proposes that more robust global and national data on antibiotic use can streamline procurement and financial decisions and, in turn, support equitable access to these medicines.
3. Partnership frameworks as catalysts for NAARs and national antibiotic policies: The final section elaborates on the partnership frameworks required to formulate NAARs and national antibiotic policies. It discusses the potential integration of multi-disciplinary technical capabilities across key stakeholders to better monitor antibiotic use and the trajectory of AMR.

By providing a comprehensive assessment of antibiotic use and proposing robust data collection methods, this paper ultimately aims to support the development of effective national antibiotic policies and optimize the global response to AMR.