Targeted Action and Financing the Fight Against Antimicrobial Resistance in Asia 2025

Change in global antibiotic consumption, by country and country income classification (2016-2023) FIGURE 6 0 10 20 Absolute change in defined daily dose per 1,000 inhabitants per day Notes: Absolute change in antibiotic consumption rate between 2016 and 2023 by country in DDDs per 1,000 inhabitants per day. Countries in gray have no data in the database. Data source: Based on IQVIA MIDAS® sales data for period 2016-2023. Source: Klein et al., PNAS, 2024.66Meanwhile, strengthening childhood vaccination programmes could avert 181,500 deaths by curbing antibiotic usage and limiting the conditions for resistance to develop. Much of the reduction in under-five mortality, for example, can be linked to widespread vaccination efforts, improved access to water and sanitation, and other public health interventions. This underscores the importance of infection prevention as a highly effective intervention in reducing the burden of AMR.60 Shortage of skilled practitioners In parts of Asia with a shortage of skilled healthcare practitioners and insufficient technical capacity, antimicrobial monitoring and stewardship efforts are correspondingly weak.61 This in turn can lead to inappropriate antibiotic use and inadequate infection control measures. Rampant use of counterfeit and substandard drugs The widespread availability of counterfeit or low-quality antibiotics in the region undermines treatment outcomes, increases resistance rates and erodes trust in healthcare systems.62 These substandard medications may contain insufficient active ingredients, promoting the survival and spread of resistant bacteria. A study found that South-East Asia produced more than three- quarters (78%) and consumed almost half (44%) of counterfeit antimicrobials globally.63 In November 2024, the Philippine Food and Drug Administration intercepted close to $450,000 worth of counterfeit medicines and health devices under its “Oplan Katharos” initiative.64 Overuse and misuse of antibiotics Inappropriate antibiotic usage can come from a lack of understanding, ineffective regulations, inadequate monitoring and the absence of dedicated stewardship programmes. Most countries in Asia were found to have a high absolute change in antibiotic consumption rate (measured in daily defined doses, or DDDs, per 1,000 inhabitants per day), with Viet Nam, Thailand and Malaysia among the top five countries with the greatest increases (see Figure 6).65 Misuse occurs among both patients and healthcare providers, highlighting the need for comprehensive education and regulatory efforts. A study found that South-East Asia produced more than three- quarters (78%) and consumed almost half (44%) of counterfeit antimicrobials globally. Targeted Action and Financing the Fight Against Antimicrobial Resistance in Asia 16