A major new analysis led by PSI scientists with global partners has revealed that large parts of the world have no usable genomic data on dangerous antimicrobial resistance (AMR), leaving substantial blind spots in global health surveillance.
The study, published today in PLOS Global Public Health to coincide with World AMR awareness week, found that 89 countries have no publicly available genomic data for key drug-resistant pathogens, while 146 countries have not contributed any such data since 2020. The researchers emphasise that these gaps are driven by limited laboratory infrastructure, cost barriers, and competing health priorities – not inaction by countries.
Antimicrobial resistance (AMR) occurs when pathogens no longer respond to treatment, making infections harder to cure and routine medical procedures riskier. AMR was directly responsible for 1.14 million deaths in 2021 and is projected to rise to 1.91 million by 2050, with wider impacts potentially contributing to up to 10 million deaths a year. Authors make it clear that without stronger global surveillance and coordinated action, resistant infections will continue to undermine modern medicine.
The analysis draws on data aggregated through amr.watch, a freely accessible global surveillance platform developed by scientists at PSI’s Centre for Genomic Pathogen Surveillance (CGPS). The platform automatically presents global genomic data, capturing time and location information, within a public health framework. While the platform has been publicly open for two years, this study provides the first comprehensive assessment of what the underlying global data reveal.
The study shows that although more than 620,000 genomes are available globally for analysing AMR trends, they come overwhelmingly from a small number of high-income countries. Nearly 90% originate from high-income settings, with the USA and UK together accounting for over 65% of all usable data.
In contrast, many low- and middle-income countries face significant barriers to genomic sequencing, such as shortages of trained staff, high reagent costs, intermittent access to laboratory equipment and limited data infrastructure.
Professor David Aanensen, Director of CGPS and Professor of Genomic Epidemiology at PSI, said: “COVID-19 showed how powerful genomics can be in tracking threats and guiding action. We cannot afford to lose that momentum when facing antimicrobial resistance. Despite AMR causing millions of deaths, most genomic data still comes from a handful of high-income countries, leaving dangerous blind spots. We need urgent investment in global surveillance so every region has the tools to detect and respond to emerging resistant infections.”
Lead author Sophia David said: “Genomic surveillance only works when the world is connected. amr.watch is open access, developed to support activities within the WHO Collaborating Centre on Genomic Surveillance of AMR, and gives us a shared view of how resistance is spreading and where new threats are appearing. But to make the global picture complete, we need to close the gaps. That means real investment in local expertise, common standards so data can be compared, and data sharing built on trust and shared benefit.”
Lessons have been applied from COVID-19 to the rising incidence of AMR. During the COVID-19 pandemic, rapid sharing of genomic data enabled scientists to identify variants of concern and guide interventions. The authors note that similar approaches are urgently needed for AMR, Professor Aanensen concludes, “To prepare for emerging resistant strains, we need timely and representative genomic data from all regions, not just a handful. This study provides a roadmap for where effort is most needed to build truly global surveillance.”
The call for swift action is echoed in a recent article in the The Lancet Infectious Diseases, where Professor Aanensen and international partners advocate for genomic-led warning systems that are truly global, addressing current surveillance inequities in the regions most affected by antimicrobial resistance.
The amr.watch platform, created by the Centre for Genomic Pathogen Surveillance and a WHO Collaborating Centre, complements existing global efforts such as WHO GLASS and the Global Genomic Surveillance Strategy, to build more equitable and effective genomic surveillance worldwide.