The World Health Organization’s (WHO) latest report has identified India as one of the largest contributors to the escalating global antimicrobial resistance (AMR) crisis, warning that one in every six bacterial infections worldwide is now resistant to antibiotics.
According to the Global Antibiotic Resistance Surveillance Report 2025, nearly 41% of all documented bloodstream infection cases originated from just three countries — China, India, and Pakistan — among the 61 nations from which data was collected. Similarly, 42% of gastrointestinal infection cases were reported from China and the Islamic Republic of Iran, while 42% of urinary tract infection cases came from India, Iraq, Iran, and Pakistan, out of the 74 reporting countries.
Understanding Antimicrobial Resistance (AMR)
Antimicrobial resistance refers to the ability of bacteria to evolve and survive exposure to drugs designed to eliminate them. The WHO has classified AMR as one of the top ten global public health threats, as it undermines the effectiveness of essential medical treatments and places millions at risk of untreatable infections.
The report highlights that antibiotic resistance in Gram-negative bacterial pathogens—common in water, food, the environment, and the human gut—poses a particularly severe and growing threat. These bacteria are responsible for diseases such as urinary tract infections (UTIs), pneumonia, and foodborne illnesses.
Between 2018 and 2023, resistance increased in over 40% of monitored antibiotics, with an annual rise of 5–15%. Globally, antibiotic resistance for UTIs exceeded 30%, while resistance to third-generation cephalosporins—first-line antibiotics for many infections—was reported in over 40% of E. coli and 55% of K. pneumoniae cases.
The WHO also noted that resistance levels are disproportionately high in low- and middle-income countries, particularly those with weak healthcare infrastructures.
The Rise of ‘Superbugs’
The term superbug refers to bacterial strains resistant to one or more commonly used antibiotics. According to the Science Direct article Superbugs: An Invincible Threat in the Post-Antibiotic Era, such resistance often develops after prolonged or improper antibiotic exposure.
WHO estimates that antimicrobial-resistant superbugs directly cause over one million deaths annually and contribute to nearly five million deaths each year worldwide.
Global Efforts to Combat Superbugs
During the 79th United Nations General Assembly (UNGA) in September 2024, world leaders underscored the urgent need for coordinated global action to curb antimicrobial resistance.
The declaration followed earlier research from the University of Gothenburg (2007), which revealed severe antibiotic pollution from pharmaceutical manufacturing facilities in India. The 2024 UNGA resolution reiterated these concerns and called for stronger regulatory measures to address such pollution.
India’s AMR Burden and Response Challenges
A 2025 study by the Global Antibiotic Research and Development Partnership (GARDP) examined access to antibiotics for approximately 1.5 million cases of carbapenem-resistant Gram-negative (CRGN) infections across eight low- and middle-income countries, including India, Brazil, and South Africa.
The findings revealed that CRGN infections—caused by bacteria resistant to last-line antibiotics—pose an extreme treatment challenge, with only 6.9% of affected patients in the studied countries receiving appropriate care.
According to The Lancet Infectious Diseases, India bears one of the world’s heaviest AMR burdens, securing 80% of required antibiotic courses but managing to effectively treat only 7.8% of estimated cases.
Underlying Causes and Systemic Challenges in India
The persistence of AMR in India is attributed to a complex mix of biological, social, and systemic factors. A Nature report noted that widespread over-the-counter antibiotic sales and over-prescription in rural healthcare facilities have contributed significantly to misuse. Overcrowding, inadequate sanitation, and poor infection control further exacerbate bacterial resistance.
The misuse of antibiotics in agriculture and poultry farming adds to the problem, while socio-economic inequalities and climate change continue to accelerate the spread of resistant infections.
In conclusion, the WHO report underscores the urgent need for coordinated global and national action — including stricter antibiotic regulation, improved healthcare practices, and environmental safeguards — to combat the rising threat of superbugs and protect public health worldwide.
