Antimicrobial resistance (AMR) is one of the most urgent global health threats of our time, and it risks reversing decades of medical progress. AMR occurs when bacteria, viruses, fungi, and parasites evolve and no longer respond to the medicines designed to kill them. In the case of antibiotics, this means common bacterial infections become harder, and sometimes impossible, to treat. Every time an antibiotic is used, it creates selective pressure: bacteria that survive exposure can multiply and spread their resistant traits. Over time, this process erodes the effectiveness of even our most powerful medicines.

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In low- and middle-income countries (LMICs), the risk is particularly acute. High infection rates, limited access to diagnostics, and inconsistent medicine supply chains all increase the likelihood of antibiotic misuse and resistance. Many people in these settings also struggle to access the right antibiotic at the right time, a gap that worsens outcomes and enables resistant infections to spread.

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Here are five key things to know about antibiotic use and resistance in these settings, and how IHP is helping safeguard antibiotics for future generations:

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1. Antimicrobial resistance threatens decades of medical progress

Antibiotics have revolutionised modern medicine, enabling, for example, safe surgery and the effective management of once deadly infections. But AMR threatens to undo these advances. Without effective antibiotics, routine medical procedures could become dangerous, and treatable diseases could again become fatal. LMICs bear the heaviest burden, with resistant infections already contributing to high mortality rates and longer hospital stays. Many people in these countries still struggle to access effective antibiotics when they need them, a gap that worsens outcomes and allows resistant infections to spread unchecked.

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IHP plays a vital role in addressing this access gap. By sourcing essential medicines, including antibiotics, from trusted corporate donors and distributing them safely and responsibly, IHP helps bridge the gap, ensuring that more people receive the treatment they need when they need it. In 2025, IHP has shipped antibiotics to support care for more than 310,000 people.

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2. Misuse and overuse drive resistance

Resistance is accelerated by inappropriate antibiotic use, such as taking antibiotics for viral infections, stopping treatment too early, or using poor-quality or counterfeit drugs. In some LMICs, antibiotics can be purchased without a prescription, making misuse more likely. Overuse of antibiotics in livestock and agriculture also contributes to the spread of resistant bacteria in communities.

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3. Humanitarian settings face unique pressures

In conflict zones and areas affected by displacement, healthcare systems are often under immense strain. Limited diagnostic capacity, stock shortages, and high infection risks can force clinicians to rely on broad-spectrum antibiotics or more potent medication when first-line options are unavailable. These pressures make stewardship – the careful management of antibiotic use – especially difficult, yet vitally important.

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IHP directly supports health workers in these environments. In crises such as Yemen and South Sudan, IHP’s Essential Health Packs include key first-line antibiotics, enabling clinicians to treat common infections effectively and avoid prematurely resorting to stronger drugs. Ensuring a steady supply of first-line antibiotics is critical in these fragile contexts, where shortages can quickly escalate into preventable AMR risks.

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4. Not all antibiotics are the same

To guide responsible use, the World Health Organization (WHO) classifies antibiotics into three main groups under the AWaRe system:

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Access: First-line antibiotics that should be widely available and used for common infections.

Watch: Second-line antibiotics with higher resistance potential are to be used more selectively.

Reserve: Last-resort antibiotics that should only be used for confirmed infections that are resistant to other options when all other treatments have failed.

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At IHP, we design our procurement and donation model around this system, ensuring health partners receive a balanced supply across categories. By prioritising sufficient quantities of ‘Access’ antibiotics, we help reduce reliance on ‘Watch’ and ‘Reserve’ medicines, preserving their effectiveness for when they are truly needed. IHP only distributes antibiotics that meet strict UK safety standards, with every batch checked and tracked through our donations platform, Boaz, to ensure partners receive trusted, high-quality medicines.

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This approach also helps tackle inequities in access: by strengthening supply chains for appropriate, high-quality drugs, IHP supports both stewardship and availability, two sides of the same coin in the global fight against AMR.

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5. Partnerships are key to protecting the future

No single organisation can tackle AMR alone. By working with partners across the health and humanitarian sectors, IHP helps ensure that clinics have dependable access to the first-line antibiotics they need. This reliable supply enables responsible use, reducing pressure to turn to stronger medicines and supporting better stewardship in fragile health systems.

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Global cooperation also remains essential, as many patients in low- and middle-income countries still go untreated for resistant infections simply because the right antibiotics are not available.

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During Antibiotics Awareness Week, IHP highlights this shared responsibility. Every medicine shipped, every partnership formed, and every stewardship decision contributes to the vital goal of preserving antibiotics as a global resource for future generations.

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