Imagine a world where simple infections become deadly because antimicrobials (medicines used to prevent and treat diseases) no longer work. This is not a distant dystopian future, it is a reality we are heading towards if we do not act now. Antimicrobial resistance (AMR), when bacteria, viruses, fungi, and parasites no longer respond to antimicrobial medicines, is a growing crisis worldwide, and Pakistan is among the countries most affected. But what does this mean? And what can we do to stop it?
Antimicrobial resistance (AMR) is a major global health threat that occurs when infections no longer respond to the medications used to treat them, making them harder to treat and increasing the risk of severe illness, disability, and death. According to global estimates, AMR was directly responsible for approximately 1.27 million deaths in 2019, with millions more affected by resistant infections due to limited treatment effectiveness. Tragically, one child dies every three minutes from multidrug-resistant organism sepsis—when bacteria responsible for an infection are resistant to common antibiotics. In Pakistan, AMR was the third leading cause of death in 2019, with alarmingly high resistance levels observed in several common disease-causing organisms. These include Escherichia coli (E. coli), which causes gastrointestinal infections; Klebsiella pneumoniae (K. pneumoniae), a major cause of pneumonia and Methicillin-resistant Staphylococcus aureus (MRSA), for bloodstream infections.
As researchers, we’re dedicated to finding solutions to this growing threat. When these bacteria become resistant to treatment, even routine infections can become life-threatening. In the United States, over 2.8 million antibiotic-resistant infections occur annually, causing more than 35,000 deaths according to the Centers for Disease Control and Prevention (CDC) and in Pakistan Antimicrobial resistance contributes to 200,000 annual deaths according to the World Health Organization. A World Bank report warns that AMR could cost up to $1 trillion to the annual global gross domestic product (GDP) by 2050. In Pakistan, surveillance efforts have expanded significantly, as seen in the National AMR Surveillance Report 2021–2022, which covered over 229,000 bacterial isolates across 26 sentinel sites (a network of specific locations that collect detailed health data to monitor diseases and trends in a larger population). However, more inclusive approaches are still needed. For instance, the report lacks gender-disaggregated data, limiting the ability to understand how AMR affects women and children differently. Without this level of detail, targeted interventions to protect vulnerable groups will remain challenging to design and implement.
This is exactly the gap Jhpiego’s recent consultations sought to address.
Recognizing these critical gaps in gender data and surveillance, Jhpiego recently gathered experts to find a solution. A national roundtable discussion on Gender Inequalities and AMR was held, attended by policymakers, clinicians, laboratory experts, veterinarians, academics, and public health leaders. Tigistu Adamu Ashengo, Chief Medical Officer at Jhpiego, presented insights on AMR and infectious diseases, while Elizabeth Arlotti-Parish, the former Principal Technical Advisor for Gender at Jhpiego, shared a powerful expert perspective. Their contributions sparked thoughtful dialogue among stakeholders, including National Institutes of Health (NIH) leadership, the Fleming Fund, Pathfinder, and other partners.
Building on the roundtable, Jhpiego, in collaboration with the NIH and the Fleming Fund, led a Consultative Workshop to begin drafting Pakistan’s first Gender-Specific AMR Strategy. Using WHO’s key thematic recommendations, participants worked across four thematic areas—Human Health, Animal Health, Agriculture, and Climate—to design strategic actions, define roles, and set realistic timelines. The outcomes of these discussions are now informing the development of a national strategy that recognizes how AMR impacts women, men, and communities differently.
Several key insights emerged through discussions during the Jhpiego-hosted AMR and gender events:
Systemic Challenges
Community Level Challenges
AMR is a silent but deadly threat. We can still act and reverse the damage before it’s too late.
By strengthening governance, improving prevention and surveillance, regulating antibiotic use, and spreading awareness, while advancing equality and empowering women across these approaches, we can slow the spread of AMR and protect future generations.
The fight against AMR is not just for doctors and scientists, it’s for all of us. The choices we make today will determine the health of tomorrow. Let’s work together to keep antimicrobials effective and safeguard public health for years to come!
Dr. Aminah Khan is the Country Director for Jhpiego Pakistan.
Dr. Tigistu Ashengo is Jhpiego's Chief Medical Officer.
