Antimicrobial resistance (AMR) and non-communicable diseases (NCDs) are critical global public health challenges confronting the world today. Globally, AMR is associated with almost 5 million deaths every year (and directly responsible for 1.14 million deaths annually), and NCDs (like cardiovascular diseases such as heart diseases and stroke, cancers, diabetes and chronic respiratory diseases) kill more than 40 million people every year.
AMR and NCDs are deeply interconnected- biologically, socially, and systematically, and they amplify the impact of each other. Both disproportionately affect low- and middle-income countries, exacerbating health inequities and straining already fragile health systems.
Multiple intersections between NCDs and AMR
People with NCDs are more vulnerable to infections due to their weakened immune system, and frequent visits to healthcare settings. They often require repeated or prolonged antimicrobial treatments for the infections, thus increasing their likelihood of acquiring drug-resistant infections. AMR complicates the management of NCDs.
While speaking at the Global Dialogue for bridging the divide between AMR and NCDs, organised by the World Health Organization (WHO) and WHO Task Force of AMR Survivors, Téa Collins, Lead of NCD Department at the WHO said, "AMR and NCDs also share common risk factors like tobacco and alcohol use, poor diets, physical inactivity, and air pollution. These are the factors that exacerbate all the conditions that affect human body and weaken their immune system. So, they become more prone to having all the complications of AMR as well as poor NCDs outcomes. Add to this social, economic, environmental determinants, such as poverty, low health literacy, limited access to healthcare services and poor housing conditions and other socio-economic determinants.”
Caline Mattar, policy expert for the World Medical Association, pointed out that, “A clinician caring for a patient recognises that an infection is right around the corner. But there is also some helplessness in those physicians, who are not specialists, as they do not know how to treat a serious infection or a drug-resistant infection for their patient. This boils down to the resources, whereby high-income countries have specialists, or specialists are mostly concentrated in urban areas."
According to Mattar, “We absolutely need the infection, prevention side of things, alongside access to timely diagnostics and treatment. There should also be capacity building, education and resourcing of the health workforce within the NCD space to address AMR and drug-resistant infections and their prevention. And also pay attention to social determinants of health, because health inequities shape AMR and NCDs."
John Kirkness, Head of the Department for analysis and politics at the Norwegian Cancer Society highlighted that AMR and cancer care intersect as cancer patients are particularly prone to infections. He pointed out that nearly one in five patients undergoing cancer treatment ends up with hospitalisation due to infections. But there is very limited data on how many cancer patients get and die from infections.
"People in general and decision makers are not aware of the link between AMR and cancer. So we need to do more communication and awareness work," he said.
For him, “The lived experiences of patients must inform our policies and drive our commitment to equity and resilience to address AMR and NCDs effectively. To go far we must go together.”
Brandon Jaka, member of the WHO Task Force of AMR Survivors, rightly remarks that “As someone who has lived through the trauma of drug resistant HIV, I have realised that stories like mine are not just personal, but political. They bring a human face to AMR and help to shift the narrative from just abstract statistics to lived realities. For patients in low- and middle-income countries, the barriers are not just medical - they are also systemic. And so we must advocate for affordable diagnostics, equitable access to effective antimicrobials, and a strong community-based surveillance. If we want to build strong or resilient health systems, we must start by listening to those who have lived through their failures."
Neda Kostova, President of Patients for Patient Safety Observatory and Chair of the AMR Patient Alliance, adds that "Patient stories are just the tip of the iceberg. There are plenty more of those struggles and experiences that can be used to shape the healthcare systems better for a person-centred, value-based care. Patient reported experiences are valuable for shaping healthcare systems. The struggles happening beyond the healthcare system and the quality of life of patients also need to be captured."
A 3 times kidney transplant survivor Borislava Ananieva of the European Patients Forum rues that health literacy is missing in many national landscapes, and there is a huge difference in how patients are treated in different countries in Europe, let alone globally.
Sharing her own experience as a kidney transplanted patient, she said that when she has urinary tract infection, she has to wait for 3 days to receive the results of the diagnostic tests. So meanwhile doctors start her on some random antibiotic just to lower the infection level, because otherwise she risks losing her kidney and potentially her life. This makes her more prone to antimicrobial resistance.
"We need to be prescribed the right antibiotic at the right time, and that means rapid diagnostics which are not as rapid and specific as we need them to be. We need further research and development of the diagnostics of microbiology. Let us not forget that patients are the largest minority in the world that keeps on increasing at any given time. Also every one of us can become a member of this minority. So this is not something that is specifically targeted to patients. This is targeted to every person on this planet," she said.
Ella Balasa, member of the WHO Task Force of AMR Survivors, and living with a rare genetic lung disease called cystic fibrosis, shared that infections- especially antimicrobial resistant infections- have had a significant impact on her life.
"Our stories humanise the statistics, and reveal the gaps in care and the fear of ineffective treatments, and the burden that it places on our families and our communities. But patient voices are often missing from the policy tables. By elevating patient voices, we can shape a more inclusive and responsive health agenda. We need to develop integrated strategies across programs that include stewardship, infection and prevention, control, including vaccinations, awareness and education," said Balasa.
The common thread running across the discussion spotlighted survivor-led advocacy, breaking down silos between AMR and NCDs, elevating patient voices in global health policy, advancing integrated and person-centred care models, and strengthening collaboration across sectors.
The dialogue also presented a draft Call to Action aimed at informing 80th United Nations General Assembly High Level Meeting (UNHLM) on NCDs and Mental Health- calling upon world leaders, policymakers and global health institutions to recognise and act on the urgent, interconnected threats posed by these two major global health crises.
And as Felix Liau, member of the WHO Task Force of AMR Survivors put it succinctly: "We call on world leaders, policymakers and global health institutions to recognise and act on the urgent interconnected threats posed by these two global health crisis. The 2025 high level meeting must be a turning point that unites efforts against AMR and NCDs in a shared fight for help with equity and dignity."
People with NCDs are more vulnerable to infections due to their weakened immune system, and frequent visits to healthcare settings. They often require repeated or prolonged antimicrobial treatments for the infections, thus increasing their likelihood of acquiring drug-resistant infections. AMR complicates the management of NCDs.
While speaking at the Global Dialogue for bridging the divide between AMR and NCDs, organised by the World Health Organization (WHO) and WHO Task Force of AMR Survivors, Téa Collins, Lead of NCD Department at the WHO said, "AMR and NCDs also share common risk factors like tobacco and alcohol use, poor diets, physical inactivity, and air pollution. These are the factors that exacerbate all the conditions that affect human body and weaken their immune system. So, they become more prone to having all the complications of AMR as well as poor NCDs outcomes. Add to this social, economic, environmental determinants, such as poverty, low health literacy, limited access to healthcare services and poor housing conditions and other socio-economic determinants.”
Caline Mattar, policy expert for the World Medical Association, pointed out that, “A clinician caring for a patient recognises that an infection is right around the corner. But there is also some helplessness in those physicians, who are not specialists, as they do not know how to treat a serious infection or a drug-resistant infection for their patient. This boils down to the resources, whereby high-income countries have specialists, or specialists are mostly concentrated in urban areas."
According to Mattar, “We absolutely need the infection, prevention side of things, alongside access to timely diagnostics and treatment. There should also be capacity building, education and resourcing of the health workforce within the NCD space to address AMR and drug-resistant infections and their prevention. And also pay attention to social determinants of health, because health inequities shape AMR and NCDs."
Double trouble: AMR and cancer
John Kirkness, Head of the Department for analysis and politics at the Norwegian Cancer Society highlighted that AMR and cancer care intersect as cancer patients are particularly prone to infections. He pointed out that nearly one in five patients undergoing cancer treatment ends up with hospitalisation due to infections. But there is very limited data on how many cancer patients get and die from infections.
"People in general and decision makers are not aware of the link between AMR and cancer. So we need to do more communication and awareness work," he said.
Include AMR in cancer control plans
According to Kirkness the Union of International Cancer Control (UICC) is currently working on pushing for inclusion of AMR in all National Cancer Control Plan. He urged for more collaboration in one health perspective, with actors also from outside the Cancer and AMR family.
Lauren Protoris, CEO and Founder of Campaigning for Cancer, voices similar thoughts: "Many cancer patients are immunocompromised, and face prolonged exposures to healthcare settings which heightens their risks of infections. When an infection becomes resistant, it has devastating consequences on the patient, not only just medically, but also financially and emotionally. Cancer patients are falling through the cracks where we have a two siloed responses- one focused on infection and the other on some chronic disease. We need to integrate the approaches and we need to see the patient as a whole."
"We must push for policy change and advocate for cancer care models that do not just treat infections as a side issue, but as a core component of the treatment planning for a cancer patient. We have to frame AMR as a survival issue for cancer patients, not just as a microbial one," she added.
Dr Yvan Hutin, Director of the Department of Universal Health Coverage, Communicable Diseases, at the WHO Regional Office for the Eastern Mediterranean stresses upon “strengthening health systems to provide quality healthcare to all; redesigning the food system to support healthy diets while reducing antimicrobial use in food production; promoting antimicrobial stewardship across human and animal health, agriculture and the environment sectors; investing in diagnostics to provide appropriate care to people suffering from infectious as well as NCDs; and promoting preventive services and behaviours."
He also calls for strengthening surveillance to monitor antimicrobial consumption and drug-resistant trends, while disaggregating this data to look at AMR burden in NCDs, and leveraging digital health and data system to track NCDs and AMR risk factors.
Professor Onyebuchi Chukwu, former Health Minister of Nigeria, suggested a three pronged approach to tackle AMR and NCDs simultaneously:
Lauren Protoris, CEO and Founder of Campaigning for Cancer, voices similar thoughts: "Many cancer patients are immunocompromised, and face prolonged exposures to healthcare settings which heightens their risks of infections. When an infection becomes resistant, it has devastating consequences on the patient, not only just medically, but also financially and emotionally. Cancer patients are falling through the cracks where we have a two siloed responses- one focused on infection and the other on some chronic disease. We need to integrate the approaches and we need to see the patient as a whole."
"We must push for policy change and advocate for cancer care models that do not just treat infections as a side issue, but as a core component of the treatment planning for a cancer patient. We have to frame AMR as a survival issue for cancer patients, not just as a microbial one," she added.
Call to strengthen health systems
Dr Yvan Hutin, Director of the Department of Universal Health Coverage, Communicable Diseases, at the WHO Regional Office for the Eastern Mediterranean stresses upon “strengthening health systems to provide quality healthcare to all; redesigning the food system to support healthy diets while reducing antimicrobial use in food production; promoting antimicrobial stewardship across human and animal health, agriculture and the environment sectors; investing in diagnostics to provide appropriate care to people suffering from infectious as well as NCDs; and promoting preventive services and behaviours."
He also calls for strengthening surveillance to monitor antimicrobial consumption and drug-resistant trends, while disaggregating this data to look at AMR burden in NCDs, and leveraging digital health and data system to track NCDs and AMR risk factors.
Professor Onyebuchi Chukwu, former Health Minister of Nigeria, suggested a three pronged approach to tackle AMR and NCDs simultaneously:
- (i) integrated policy frameworks and embedding of AMR considerations into National NCD strategies and vice versa;
- (ii) coordinated governance within and across health systems and strengthening integrated healthcare delivery, including infection prevention during patient care;
- (iii) investment in resilient health systems that are equipped to prevent, detect, and respond to both AMR and NCDs, including enhancing surveillance, promoting antimicrobial stewardship, and ensuring equitable assets to diagnostics and treatments.
For him, “The lived experiences of patients must inform our policies and drive our commitment to equity and resilience to address AMR and NCDs effectively. To go far we must go together.”
Can patient stories help shape policy conversations?
Brandon Jaka, member of the WHO Task Force of AMR Survivors, rightly remarks that “As someone who has lived through the trauma of drug resistant HIV, I have realised that stories like mine are not just personal, but political. They bring a human face to AMR and help to shift the narrative from just abstract statistics to lived realities. For patients in low- and middle-income countries, the barriers are not just medical - they are also systemic. And so we must advocate for affordable diagnostics, equitable access to effective antimicrobials, and a strong community-based surveillance. If we want to build strong or resilient health systems, we must start by listening to those who have lived through their failures."
Neda Kostova, President of Patients for Patient Safety Observatory and Chair of the AMR Patient Alliance, adds that "Patient stories are just the tip of the iceberg. There are plenty more of those struggles and experiences that can be used to shape the healthcare systems better for a person-centred, value-based care. Patient reported experiences are valuable for shaping healthcare systems. The struggles happening beyond the healthcare system and the quality of life of patients also need to be captured."
A 3 times kidney transplant survivor Borislava Ananieva of the European Patients Forum rues that health literacy is missing in many national landscapes, and there is a huge difference in how patients are treated in different countries in Europe, let alone globally.
Sharing her own experience as a kidney transplanted patient, she said that when she has urinary tract infection, she has to wait for 3 days to receive the results of the diagnostic tests. So meanwhile doctors start her on some random antibiotic just to lower the infection level, because otherwise she risks losing her kidney and potentially her life. This makes her more prone to antimicrobial resistance.
"We need to be prescribed the right antibiotic at the right time, and that means rapid diagnostics which are not as rapid and specific as we need them to be. We need further research and development of the diagnostics of microbiology. Let us not forget that patients are the largest minority in the world that keeps on increasing at any given time. Also every one of us can become a member of this minority. So this is not something that is specifically targeted to patients. This is targeted to every person on this planet," she said.
Ella Balasa, member of the WHO Task Force of AMR Survivors, and living with a rare genetic lung disease called cystic fibrosis, shared that infections- especially antimicrobial resistant infections- have had a significant impact on her life.
"Our stories humanise the statistics, and reveal the gaps in care and the fear of ineffective treatments, and the burden that it places on our families and our communities. But patient voices are often missing from the policy tables. By elevating patient voices, we can shape a more inclusive and responsive health agenda. We need to develop integrated strategies across programs that include stewardship, infection and prevention, control, including vaccinations, awareness and education," said Balasa.
The common thread running across the discussion spotlighted survivor-led advocacy, breaking down silos between AMR and NCDs, elevating patient voices in global health policy, advancing integrated and person-centred care models, and strengthening collaboration across sectors.
The dialogue also presented a draft Call to Action aimed at informing 80th United Nations General Assembly High Level Meeting (UNHLM) on NCDs and Mental Health- calling upon world leaders, policymakers and global health institutions to recognise and act on the urgent, interconnected threats posed by these two major global health crises.
And as Felix Liau, member of the WHO Task Force of AMR Survivors put it succinctly: "We call on world leaders, policymakers and global health institutions to recognise and act on the urgent interconnected threats posed by these two global health crisis. The 2025 high level meeting must be a turning point that unites efforts against AMR and NCDs in a shared fight for help with equity and dignity."
(Shobha Shukla is a feminist, health and development justice advocate, and an award-winning founding Managing Editor and Executive Director of CNS (Citizen News Service). She was also the Lead Discussant for SDG-3 at United Nations inter-governmental High Level Political Forum (HLPF 2025). She is a former senior Physics faculty of prestigious Loreto Convent College; current President of Asia Pacific Regional Media Alliance for Health and Development (APCAT Media); Chairperson of Global AMR Media Alliance (GAMA received AMR One Health Emerging Leaders and Outstanding Talents Award 2024); and coordinator of SHE & Rights (Sexual Health with Equity & Rights). Follow her on Twitter/X @shobha1shukla or read her writings here www.bit.ly/ShobhaShukla)
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| Central Chronicle, India (op-ed page, 21 August 2025) |
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- Daily Good Morning Kashmir, India (full newspaper page, 21 August 2025)
- Central Chronicle, India (op-ed page, 21 August 2025)
- Scoop Independent News, New Zealand
- Modern Ghana
- MediCircle, India
- Pakistan Christian Post
- Bihar and Jharkhand News, India
- World News (WN)
- e-Pao News Network, Manipur, India
- Op-Ed News, USA
