The WHO says fairness is missing from the fight against antibiotic resistance

What happened

On 2 September 2026, the World Health Organization published new guidance on antimicrobial resistance. Its title is a mouthful: "Integration of equity into national action plans on antimicrobial resistance". The idea behind it is simpler than the title. Antimicrobial resistance, usually shortened to AMR, is what happens when bacteria and other germs stop responding to the medicines we use against them. Antibiotics that once cured an infection quietly stop working. Almost every country now has a national plan to slow this down. The WHO's point is that most of those plans do not properly deal with fairness. Who gets clean water. Who can afford a doctor. Who can get hold of the right antibiotic at all. The guidance sets out 20 practical suggestions across three priority areas. The first is water, sanitation and hygiene. The second is access to healthcare and to antibiotics. The third is surveillance, meaning how countries track resistant infections and respond to them. The WHO says inequity can shape how resistance appears, how it spreads, and how much harm it does. It also says that ignoring fairness can make otherwise good plans fail. The document is designed to sit alongside the WHO's existing people-centred approach to AMR, and countries are expected to adapt it to their own circumstances.

Why this matters

Antibiotic resistance sounds like a problem for the future. It is not. It is already one of the largest causes of death in the world. A major analysis published in The Lancet in 2024 estimated that bacterial AMR was associated with more than 4.7 million deaths globally in 2021, and was the direct cause of about 1.14 million of them. The same work projected that, without change, those figures could rise to roughly 8.2 million and 1.9 million a year by 2050. That is the scale. The WHO's new guidance is about something narrower but still important: whether our response reaches the people who need it most. Think about what actually drives resistance. Dirty water spreads infections, so more people need antibiotics. Weak healthcare means people cannot get a proper diagnosis, so antibiotics get used as a guess. Poor supply means people take part of a course, or the wrong drug, because that is what is available. Every one of those things gives bacteria more chances to adapt. So fairness is not an add-on to fighting resistance. It is part of the mechanism. And this is not only a problem in poorer countries. Resistant bacteria travel. They move with people, food and trade. A hospital in Lincolnshire is affected by what happens in hospitals thousands of miles away.

What the evidence actually says

It is worth separating what this document is from what it is not. This is guidance, not a treaty or a law. It offers 20 suggestions for governments writing or updating their national AMR plans. It does not force anyone to do anything. The WHO's own page for the publication does not include new figures on the global burden of AMR. It focuses on the argument that equity has been "insufficiently addressed" in policy and practice, and on how to fix that. The mortality figures quoted above come from the separate Lancet analysis of the global burden of bacterial AMR, published in 2024. The guidance also sits within a bigger framework. The WHO's Global Action Plan on AMR for 2026 to 2036 aims to support a target agreed at the United Nations General Assembly in 2024: a 10 per cent reduction in deaths associated with bacterial AMR by 2030. What the evidence does not say is that antibiotics are dangerous or should be avoided. That would be the wrong lesson entirely. Antibiotics save enormous numbers of lives every year. The problem is using them when they will not help, and not being able to get them when they will. It is also worth noting what the guidance does not claim. It does not say that fixing inequity alone will solve resistance. Better diagnostics, new drugs, vaccination and infection control all still matter.

Qurexa perspective

Pharmacies sit at the point where this global problem becomes a personal one. When someone comes in with a sore throat and asks for antibiotics, the honest answer is usually that antibiotics will not help. Most sore throats, coughs and colds are caused by viruses, and antibiotics do nothing against viruses. That conversation is not always welcome, but it is the right one. The other half of the job is making sure that when antibiotics genuinely are needed, people can actually finish the course. That sounds obvious. In practice, courses get abandoned when someone feels better on day three, or when a delivery does not arrive, or when a person is juggling several medicines and loses track. That is the part we can help with directly. Getting the right medicine to the right person on time, and helping them keep to the course, is a small but real contribution to slowing resistance. If you are ever unsure whether to finish a course of antibiotics, ask a pharmacist rather than guessing. It takes a minute and it is free.

Practical advice

There are a few simple things any of us can do. Do not ask for antibiotics for a cold, flu or most sore throats. They will not work, and they carry side effects. A pharmacist can suggest something that will actually help with the symptoms. If you are prescribed antibiotics, take them exactly as directed. Follow the instructions you were given about how long to take them and when to stop. Never use antibiotics left over from a previous illness, and never take someone else's. The wrong antibiotic can fail to treat your infection while still helping bacteria adapt. Do not buy antibiotics online without a prescription. You cannot be sure what you are getting, and unregulated supply is one of the ways resistance spreads. Return unused antibiotics to a pharmacy. Do not flush them or put them in the bin. Prevent infections in the first place. Wash your hands properly. Keep up with vaccinations, including flu, because fewer infections means fewer antibiotic prescriptions. And if an infection is not getting better, or is getting worse, go back to your GP rather than assuming the medicine just needs longer.

What to know

The WHO published new guidance on 2 September 2026 arguing that national plans on antibiotic resistance need to take fairness seriously, and offering 20 suggestions on water and sanitation, access to care and medicines, and surveillance. The scale of the problem is large. Bacterial AMR was associated with more than 4.7 million deaths worldwide in 2021, according to analysis published in The Lancet, with projections of roughly 8.2 million a year by 2050 if nothing changes. The guidance is advice to governments, not a binding rule, and it does not by itself add new numbers to the picture. Resistance is not a distant problem. Resistant bacteria move between countries, so the response has to be shared. At an individual level, the most useful habits are simple: do not push for antibiotics when they will not help, take them properly when they will, and never share or stockpile them. Sources: World Health Organization, "Integration of equity into national action plans on antimicrobial resistance: guidance to complement the people-centred approach", 2 September 2026, https://www.who.int/publications/i/item/9789240123892 | World Health Organization, "Antimicrobial resistance" fact sheet, https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance | GBD 2021 Antimicrobial Resistance Collaborators, "Global burden of bacterial antimicrobial resistance 1990-2021: a systematic analysis with forecasts to 2050", The Lancet, 2024, https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01867-1/fulltext This article is for general information and does not replace advice from a doctor, pharmacist or other qualified healthcare professional. Always follow the instructions you are given with any prescribed medicine, and speak to a healthcare professional if an infection is not improving.