by Dr Saia Ma’u Piukala, WHO Regional Director 

Almost a century ago, the discovery of antimicrobials changed the course of modern medicine. We saw previously fatal infections—pneumonia, sepsis, tuberculosis—become treatable, and surgeries become safer. Millions upon millions of lives have been saved since then.

But that is changing. Today, due to misuse and overuse of these medicines, medical advances long taken for granted are at risk of being erased. Bacteria, viruses, fungi and parasites are quickly changing and becoming resistant to antimicrobials. Globally, one in six bacterial infections now resists standard antibiotics amid rising rates of resistance. The result: common infections are becoming harder to treat — increasing the risk of disease spread, severe illness and death.

As a doctor and surgeon in Tonga, I visited provincial hospitals and saw patients battling infections that no longer responded to the medicines we relied on. I remember a young child brought in with sepsis. We tried every antibiotic available, but nothing worked. Unfortunately, the child did not survive. That moment has stayed with me as a constant reminder that antimicrobials are precious, fragile tools in a physician’s arsenal - tools we are in danger of losing.

The pandemic of antimicrobial resistance – or AMR - isn’t a science-fiction scenario. In many ways, it’s already here.

Countering the threat of antimicrobial resistance

AMR is truly one of the most urgent, complex and, yes, frightening health challenges of our time. Like that young child in Tonga, as many as 5.2 million people across the 38 countries and areas of the Western Pacific Region could die as a result of drug-resistant bacterial infections between 2020 and 2030.   Globally, nearly five million deaths in 2019 were associated with bacterial AMR, with almost 1.3 million deaths directly attributed to drug-resistant infections.

It’s clear the current alarming trends demand collective regional and global action.

In response, at the 2024 United Nations General Assembly, Member States adopted a high-level political declaration on AMR — committing to a 10% reduction in deaths from drug-resistant infections by 2030.

This global commitment mirrored efforts in the Asia-Pacific region to Accelerate Action to Fight Antimicrobial Resistance, led by Japan in partnership with WHO. Our own WHO regional vision, Weaving Health for Families, Communities and Societies in the Western Pacific Region (2025−2029), echoes the urgency of addressing AMR and advocates for a One Health approach – the nexus of human, animal and environmental health.
vThe reality is that AMR doesn’t exist in isolation. Climate change, pollution, and extreme weather are also disrupting ecosystems — driving the spread of resistant pathogens through water, soil, and food systems. Protecting health therefore means protecting the planet too.

Our determination must be underpinned by resilient health systems that integrate primary health care – bringing health services to where the people are - with technology and innovation, turning AMR commitments into coordinated, measurable action.

As WHO’s Regional Director for the Western Pacific, and as a Pacific islander and medical practitioner, I understand first-hand the pervasive health inequities that impede progress in our Region.

In Tonga, as with many other countries, health workers in rural clinics lack access to microbiological testing and even antibiotics, forcing reliance on empirical and sometimes inappropriate use of antibiotics.

In hospitals across the Region, particularly in low-resource settings, antimicrobial stewardship programmes and guidelines may exist, but limited workforce capacity and delayed data feedback hinder effective implementation.

WHO has therefore prioritized AMR surveillance and data-sharing through the Global Antimicrobial Resistance Surveillance System (GLASS-AMR) that enables data-driven solutions and targeted actions.

Under GLASS-AMR, 13 Member States in our Region are already sharing data that reveal where AMR resistance is spreading and how best to respond. Many more countries are building their capacities in this area, helping form a fuller picture of the regional threat.

Additionally, WHO is building national capacities to monitor progress towards AMR goals through TrACSS, a self-assessment survey, already completed this year by 26 out of 28 Member States in the Western Pacific, the highest participation rate to date.

Taking action today: each of us has a role to play

As we mark World AMR Resistance Awareness Week 2025 under the theme “Act Now: Protect Our Present, Secure Our Future,” our Region stands at a critical turning point, one that will determine whether global commitments can be translated into tangible results for health, equity and resilience.

If we treat AMR as a distant threat, burying our heads in the sand, its consequences will devastate us both now and in the future by increasing morbidity, prolonging hospital stays, raising healthcare costs and leading to literally millions of avoidable deaths.

We must pivot from aspiration to action; there’s no time to waste.
vThrough WHO-led initiatives - including TrACSS, GLASS-AMR, hospital stewardship programs, regional networks, and country-level technical support - we are demonstrating what’s possible when leadership, evidence and community engagement come together.
vBut these efforts alone are not enough.

There are actions each of us can take individually to help collectively reverse current trends in antimicrobial resistance.

When people take antibiotics only when truly necessary — they help protect everyone from antimicrobial resistance.

When clinicians prescribe antibiotics wisely — they safeguard hard-won medical advances.

When hospitals strengthen infection prevention and invest in reliable and affordable diagnostics — lives are saved.

When policymakers embed AMR programmes into national health and development agendas, they build fit-for-purpose systems, helping ensure that the health of future generations is secured.

These interconnected actions benefit us all. Every community, hospital, and household has a stake in this war. We need champions at every level. Our strength as a Region lies in our solidarity, our shared resolve and our ability to stay the course.

We simply cannot allow AMR to erode the health gains we have built over decades. We must commit—as governments, policymakers, health workers, communities and individuals—to act now, protect our present, and safeguard our future.
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Dr Saia Ma’u Piukala is Regional Director for WHO in the Western Pacific Region.