A narrative review on global political actions and scientific interventions in tackling antimicrobial resistance

Antimicrobial resistance (AMR) represents one of the most pressing global public health threats, contributing to significant morbidity and mortality, with a disproportionate burden falling on low- and middle-income countries (LMICs). Addressing AMR requires integrated One Health framework including multisectoral strategies that span human, animal, and environmental health. This narrative review searched PubMed/MEDLINE, Embase, EBSCOhost, Google Scholar, the Cochrane Library, CINAHL, and WHO/FAO grey literature repositories for studies published between January 2010 and April 2025, supplemented by seminal earlier foundational works. Primary search terms included: antimicrobial resistance, antibiotic resistance, One Health, global action plan, national action plan, antimicrobial stewardship, phage therapy, antimicrobial peptides, essential oils, nanoparticles, and LMIC surveillance. The study synthesized evidence on global political framework, educational and stewardship interventions, and alternative/emerging scientific solutions including antimicrobial peptides, essential oils, nanoparticles, metagenomics, and phage therapy. This review provides an integrated appraisal within a unified One Health framework and introduces a prioritized, temporal actionability framework for policymakers. Critical gaps identified include inadequate laboratory and surveillance infrastructure in LMICs, weak translational pipelines for alternative therapies, and insufficient enforcement mechanisms in international AMR governance. Combating AMR requires not only coordinated multisectoral action but also governance frameworks that institutionalize accountability, evidence-based prioritization, and sustained funding across immediate, medium-term, and long-term horizons.