Progress on the Global Research Agenda for Antimicrobial Resistance in Human Health in Pakistan: Findings and Implications

Background and Objective: Antimicrobial resistance (AMR) poses a formidable challenge to global public health, with low- and middle-income countries (LMICs) including Pakistan being particularly vulnerable. This study assesses the progress made in Pakistan following the Global Research Agenda for AMR, which builds on the key activities and goals of its national action plan to reduce AMR. The intention is to identify key gaps, achievements, and future areas of focus to help reduce rising AMR rates in Pakistan. Methods: Utilizing a systematic-narrative hybrid literature review methodology approach, recent research publication and policy initiatives related to AMR, including those published on the internet, were examined and documented. Findings: The findings from 349 published studies were divided into the 40 research priority areas. This included 23 papers (9.95%) specifically related to prevention and 55 (22.9%) to diagnosis, 64 (26.7%) for treatment and care of patients with infectious diseases, 59 (24.5%) for cross-cutting, and 44 (18.33%) for drug-resistant tuberculosis (TB). Currently, research on AMR in Pakistan is primarily concentrated in major urban centers across a limited number of cities. This needs addressing going forward. To effectively combat AMR in Pakistan, prioritizing prevention is crucial to curb disease spread and reduce reliance on prophylactic treatments, especially inappropriate prescribing and dispensing of antimicrobials. Enhancing diagnostic facilities, strengthening antimicrobial surveillance systems and promoting appropriate management of patients with infectious diseases, supported by robust antimicrobial stewardship programs, can also help enhance judicious antibiotic use in Pakistan and reduce AMR going forward. Conclusion and Interpretation: There are ongoing concerns regarding current research activities in Pakistan to reduce AMR. The pathway forward in Pakistan includes leveraging global partnerships to share knowledge, resources, and strategies to enhance the use of Access antibiotics as well as reduce AMR to reach agreed United Nations’ goals.