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Antimicrobial resistance is a growing public health crisis, especially in countries with fragile health systems, population displacement or ongoing conflict. In 2019 antibiotic-resistant bacteria directly caused an estimated 1.27 million deaths, and contributed to 4.95 million deaths, tolls that will continue to increase if no effective action is taken.

MSF’s approach to combatting antimicrobial resistance combines three pillars: infection prevention and control, microbiology and surveillance, and rational use of antibiotics via antibiotic stewardship. Several studies characterize patterns and prevalence of antibiotic resistance among MSF patients, from civilians wounded in Middle East conflicts to hospitalized neonates in Central African Republic and Haiti. New technologies developed by MSF and partners are expanding local capacity for rapid, accurate laboratory diagnosis of infections, so that clinicians can prescribe the right antibiotic for each patient. Other work assesses the practices and challenges related to optimizing rational antibiotic use within health facilities and communities.