Health System and AMR

A critical relationship exists between health systems and antimicrobial resistance (AMR), which highlights how system structures and functions both drive and defend against this global health threat. AMR undermines the effectiveness of modern medicine, increasing mortality, morbidity, healthcare costs, and jeopardising essential services such as surgery and cancer care. Using the World Health Organisation’s health system framework, one can analyse how governance, service delivery, financing, workforce, information systems, and access to medicines shape AMR dynamics. Key pathways include inappropriate prescribing, inadequate infection prevention and control (IPC), weak diagnostic and surveillance capacity, and perverse financial incentives. Several evidence-based interventions, such as antimicrobial stewardship programmes, IPC integration, strengthening diagnostic and surveillance capabilities, and One Health coordination, have gained importance in contributing to the control of AMR. A few innovations in stewardship metrics, digital health, and financing models to stimulate research and ensure equitable access have also become available and used. Despite demonstrated effectiveness, challenges persist in scaling and sustaining interventions, particularly in resource-limited settings with fragile laboratories, workforce shortages, and weak governance. The WHO’s 2023 people-centred approach is presented as a paradigm shift, placing communities and equitable access at the core of AMR strategies. Countries need to identify and implement priority policy recommendations to embed AMR containment into routine health system strengthening and governance reforms.