Many countries have national plans to preserve antimicrobial medicines like antibiotics, but many more must also step up, the World Health Organisation said, after a recent survey.

The new report reveals that while much activity is underway and many governments are committed to addressing the problem, there are major gaps in action to prevent the misuse of antibiotics and reduce antimicrobial resistance.

“This is the single greatest challenge in infectious diseases today,” said Dr Keiji Fukuda, WHO’s Assistant Director-General for Health Security. “All types of microbes — including many viruses and parasites — are becoming resistant to medicines. Of particularly urgent concern is the development of bacteria that are progressively less treatable by available antibiotics. This is happening in all parts of the world, so all countries must do their part to tackle this global threat,” he added.

Coming a year after WHO’s first report on antimicrobial resistance globally, which warned of a ‘post-antibiotic era’ – this survey (of 133 countries in 2013, 2014) is the first to capture governments’ own assessments of their response to resistance to antimicrobial medicines used to treat conditions such as bloodstream infections, pneumonia, tuberculosis (TB), malaria and HIV.

While monitoring is key to control antibiotic resistance, the WHO found it was infrequent. In many countries, poor laboratory capacity, infrastructure and data management prevent effective surveillance, which can reveal patterns of resistance and identify trends and outbreaks.

Besides, sales of antibiotics and other antimicrobial medicines without prescription remain widespread, with many countries lacking standard treatment guidelines, increasing the potential for overuse of antimicrobial medicines by the public and medical professionals, it cautioned.

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