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WHO Background Guide
Agenda: Tackling Antimicrobial Resistance in Global Health
Chairperson’s Letter
Dear Delegates,
We are thrilled to welcome you to the World Health Organization committee of Schoolhouse MUN 2025! As your committee chairs, we are committed to making this a space where you can engage in thoughtful discussions and collaborate to create meaningful resolutions.
Meet Your Chairs
Claire: I am a rising college senior majoring in Public Health at the University of Alabama Online. I am also an intern for the World Health Network, where I practice science communication and teamwork with a team of scientists, lawyers, and regular people dedicated to improving public health and infection control.
Two and a half years ago, I was one of you—a Schoolhouse learner excited for her very first Model UN. In this WHO committee, I hope to combine my love of public health with my passion for public speaking to provide you with an engaging and informative experience.
Hafsah: I am a rising junior in high school with my interests ranging from cognitive science, CS, math to history, philosophy and linguistics. I am very excited to be one of the WHO committee chairs, in addition to being the conference’s Secretary General. Model UN has been a major passion of mine, right from when I started participating in 6th grade - I’ve placed in every conference I have participated in, and I was Secretary General for the first two editions of the Schoolhouse MUN in 2023 and 2024. I’m excited to see what you all bring to this committee!
Introduction to the Committee and Agenda:
The World Health Organization is the United Nations’ agency dedicated to global health, well-being, workplace safety, and infection prevention. The World Health Organization was the first specialized UN agency subscribed to by every member state, and it currently has almost 200 members.
Antimicrobial treatments, including antibiotics and antifungals, have become powerful tools in the arsenals of doctors, healthcare systems, and farmers to combat disease in humans and animals. However, microbes are developing resistance to these drugs people around the world rely upon. Thus, this committee is dedicated to controlling the spread and mitigating the impact of antimicrobial resistant organisms globally. Our agenda will include preventing, tracking, and containing antimicrobial resistance and developing alternatives to standard antimicrobial treatments. We will also seek to educate members of the public and healthcare workers on antimicrobial resistance and its prevention. International cooperation is vital to address this widespread and mobile threat.
We encourage you to gain a deep understanding of your country’s experience with antimicrobial resistance while seeking global solutions and international coordination. Your resolution should demonstrate your understanding of geopolitical dynamics, resource allocation, the role and reach of governments, and the involvement of non-governmental organizations. You should also consider the structures of diverse healthcare systems and the scientific, social, economic, and environmental factors that affect antimicrobial resistance. Our goal is not only to keep resistant microorganisms from spreading but also to prevent the evolution of resistance and invest in alternatives to standard antimicrobial treatments.
Delegates, we expect you to present creative, thoughtful, and efficient solutions to antimicrobial resistance that can adapt to the various capacities and needs of countries with diverse histories and levels of economic development. Consider frameworks that allow for inclusive surveillance, shared discoveries, and swift containment. Don’t be afraid to expound upon new discoveries, challenge ineffective responses, and boldly innovate in committee. We look forward to WHO debates dedicated to respectful communication, international cooperation, and creative problem solving!
Hafsah M and Claire A
WHO Chairs
Background Guide
Introduction
In his 1945 Noble Lecture, Alexander Fleming, who had discovered penicillin less than two decades earlier, gave a grave but prescient warning concerning the new wonder drug. “The time may come,” he declared, “when penicillin can be bought by anyone in the shops. Then there is the danger that the ignorant man may easily underdose himself and by exposing his microbes to non-lethal quantities of the drug make them resistant” (1). Today, Fleming’s prediction has been proven true. In many countries around the globe, especially low-income countries, antibiotics are available without a prescription (2). Even when a prescription is required, antibiotics are commonly prescribed when they are not needed (3). A combination of overuse in humans and animals and underdosing has created a perfect storm of antimicrobial resistance worldwide.
What is Antimicrobial Resistance?
Antimicrobial resistance (AMR) occurs when bacteria, viruses, fungi and parasites evolve in a manner that antimicrobial medicines, such as antibiotics, antivirals and antifungals, no longer work effectively. This makes infections harder to treat, increasing the risk of disease spread, severe illness, disability and death. While antimicrobial resistance is a natural process, it is accelerated by factors including the improper use of antimicrobial drugs. (4,5)
Antimicrobial-resistant germs can survive exposure to drugs that would normally kill them, continuing to grow and spread, making infections much more difficult to treat, which results in longer hospital stays, more expensive treatments, and increased mortality rates. AMR already contributes to over a million deaths annually, and global estimates suggest that this could increase to 10 million fatalities per year by 2050. (5)
Causes of Antimicrobial Resistance
One of the primary causes of antimicrobial resistance is the misuse of antimicrobial medicines in humans, animals and agriculture. This includes prescribing antibiotics, meant for treating bacterial infections, for viral infections and using antibiotics to promote animal growth. Environmental Contamination also plays a key role - antibiotic residues from farms, pharmaceutical factories and healthcare facilities seep into water and soil, further encouraging resistant strains to thrive. Additionally, several countries struggle with limited laboratory networks and weak monitoring, making it harder to detect and contain resistant strains earlier. (4)
The Global Burden
In 2019, 4.95 million people around the world died of antimicrobial resistant infections (6). Of these, 1.27 million deaths would have been averted if all these infections had been susceptible to treatment (6). The most deaths per capita occurred in Sub-Saharan Africa while the fewest occurred in Australasia (6). Antibiotic resistance also has massive economic costs for countries around the world, with billions of dollars of direct and indirect costs suffered by large countries such as China and the United States.
Antimicrobial resistance leads to other negative outcomes in healthcare, such as increased length of stay and readmission to the hospital. Antibiotic resistant infections do not cleanly replace more treatable infections that would have happened anyway; instead, antimicrobial resistance also increases the overall case count (7). Antimicrobial resistance necessitates drastic infection control measures and disrupts everyday medical procedures. In recent years, the COVID-19 pandemic and antimicrobial resistance have compounded each other, leading to an increased burden of AMR (8).
How Governments Across the World Are Responding
In May 2015, the World Health Organization’s assembly produced an action plan for antimicrobial resistance, targeting education, surveillance, sanitation, responsible use, and investment in new tools (9). Partnering with the Food and Agriculture Organization and World Organization for Animal Health, the WHO also created a monitoring and evaluation framework for this Global Action Plan (10). A 2024 high-level UN meeting put forward a new Political Declaration, including a commitment to reduce global deaths associated with bacterial AMR by 10%, or roughly half a million deaths, by 2030 (11).
Several individual governments are also responding to antimicrobial resistance. In the United States, the National Action Plan for Combatting Antibiotic-Resistant Bacteria, 2020-2025 includes improved surveillance and diagnosis, increased reporting of antibiotic use, stronger outbreak control, and investment in new therapeutics and vaccines (12). The Chinese National Action Plan for Combatting Antimicrobial Resistance (2022-2025) calls for improved control of emerging resistant microbes, stronger surveillance, research and development for new treatments and diagnostics, reference laboratory performance standards, and international cooperation (13).
In India, the National Programme on AMR Containment focuses on surveillance, antimicrobial stewardship, infection control, and education (14). In 2024, Nigeria released its Second National Action Plan on AMR, highlighting objectives including surveillance, research and development, antimicrobial stewardship, and strengthened healthcare systems (15). The European Union has also responded to antimicrobial resistance, largely focusing on a One Health approach (16).
Alternatives to Standard Antimicrobial Treatments
In order to combat antimicrobial resistance, healthcare workers and pharmaceutical companies have developed a number of new and varied treatments. One solution is combining multiple drugs into a single treatment regimen to make it more difficult for microbes or viruses to develop resistance to the combined therapy. For example, modern Human Immunodeficiency Virus (HIV) treatments use combinations of two or more different medications (17).
Another response to antimicrobial resistance is developing new classes of antibiotics and other treatments. However, this option simply buys more time, given that microbes will quickly develop resistance to the new treatments.
Drugs of last resort, such as carbapenem antibiotics, are rarely-prescribed antimicrobials that are used only when other treatments fail. This strategy seeks to prevent antimicrobial resistance from developing to these treatments, and many drugs of last resort are also withheld because of severe side effects or risks to the patient. However, resistance to drugs of last resort is rising (4).
Perhaps the solution to antimicrobial resistance lies in previously underexplored types of treatment, such as bacteriophages, viruses that infect bacteria. Since bacteriophages can undergo coevolution with bacteria, it is difficult, although not necessarily impossible, for the bacteria to become resistant to them. However, these treatments require a great deal more research before they can be safely and reliably deployed in people and animals (18).
The Current Situation Across the Globe
The Americas
In 2019, roughly 43% of infection-related deaths in the Americas involved antimicrobial resistance (19). 569,000 deaths were associated with antimicrobial resistance, and 141,000 deaths were attributable to antimicrobial resistance (19). Death rates were highest in Haiti, Bolivia, Guatemala, Guyana, and Honduras and lowest in Canada, the US, Colombia, Cuba, Panama, Costa Rica, Chile, Venezuela, Uruguay, and Jamaica (19). AMR was the third or fourth leading cause of death in 29 of 35 American countries (19). Current rates are likely higher due to the impacts of the COVID-19 pandemic. AMR also has an economic impact. For example, antimicrobial resistance directly costs the United States $4.6 billion in healthcare costs every year (8).
South Asia
In South Asia, AMR is a growing crisis worsened by dense populations, lax regulation, and widespread antibiotic misuse. For instance, in Nepal, recent surveillance across 26 hospitals detected high levels of multidrug resistance in common pathogens such as E. coli (51 %), Klebsiella spp. (56 %), and Acinetobacter species (72 %), along with rising resistance to third-generation cephalosporins and carbapenems. (21) To respond, Nepal has embraced a One Health strategy and adopted digital innovations like Robotic Process Automation (‘bots’) to streamline data collection across its surveillance network, boosting the speed and accuracy of reporting. (22)
Central Asia
Central Asian nations are part of CAESAR, the WHO-led Central Asia and European AMR surveillance network that harmonizes data from countries beyond the EU/EEA. This collaborative system captures surveillance data on invasive infections (like bloodstream infections) and allows comparison across member states, strengthening understanding of regional AMR trends. While this is an important step, the region still needs more investments in laboratory capacity and data sharing to strengthen early detection and coordinate AMR containment effectively. (23)
Europe
In Europe, AMR patterns differ markedly by region. EU surveillance data show that, in 2023, MRSA bloodstream infection rates decreased modestly, yet carbapenem-resistant Klebsiella pneumoniae increased by about 60% compared to 2019, pushing the EU off track from its 2030 reduction targets. (24) Overall AMR levels remain high, particularly in southern and southeastern countries, and over 35,000 deaths per year in the EU/EEA are attributed directly to antimicrobial-resistant infections. The ECDC warns that without stronger action - like better infection control, stewardship, and diagnostics - the region will struggle to meet its AMR reduction goals. (25)
Africa
In 2019, an estimated 1.05 million deaths in Africa were associated with antimicrobial resistance, with 250,000 deaths attributable to AMR (20). Streptococcus pneumoniae, Klebsiella pneumoniae, Escherichia coli, and Staphylococcus aureus were the greatest contributors (20). In Sub-Saharan Africa in particular, the proportion of infectious deaths associated with AMR is relatively low, yet Sub-Saharan Africa has the world’s highest death rates for antimicrobial resistance (6). In North Africa and the Middle East, rates of death associated with AMR are much lower (6).
Oceania
In the Western Pacific region, including Oceania, AMR poses a grave threat: projections suggest up to 5.2 million deaths and US $148 billion in economic losses by 2030 if current trends continue. Australia leads the regional response with its national AURA program, which tracks both antimicrobial use and resistance to inform policy and practices. Meanwhile, many Pacific Island nations face persistent challenges such as weak surveillance systems and limited laboratory capacity, although these countries are actively implementing integrated One Health strategies and strengthening laboratory networks with WHO support. (26)
Questions a Resolution Must Answer (QARMA):
How can the WHO contribute to the global fight against antimicrobial resistance?
What changes will be expected in countries with widespread antibiotic use? What about countries where antibiotics are difficult to come by?
What changes must be made in the agricultural sector?
How can countries collaborate to improve surveillance and research and development?
How will WHO contribute to the development of new vaccines, treatments, and diagnostics?
How best can antimicrobial resistant infections be controlled? How can healthcare systems respond to outbreaks? What new sanitation requirements will prevent spread?
How can WHO ensure equitable access to effective antimicrobials while preventing overuse?
What steps can WHO take to address counterfeit or substandard medicines that contribute to resistance?
How can WHO work with other UN agencies (e.g., FAO, UNEP, OIE) to address the One Health dimensions of AMR?
References and Resources:
3:
https://www.pbs.org/wgbh/frontline/article/30-of-prescribed-antibiotics-arent-necessary-study-finds/
8:
12:
19: 20:
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