Multidrug resistance (MDR) is a precisely defined laboratory category, and the One Health approach explains why controlling it depends on people, animals, plants, food systems and the environment working together rather than on hospitals alone. The current global policy reference is the Global Action Plan on antimicrobial resistance (AMR) for 2026–2036.
What multidrug resistance means
MDR is defined by a pattern of laboratory results, not by a single drug. The World Health Organization (WHO) defines it as non-susceptibility to at least one agent in three or more antimicrobial categories. “Non-susceptibility” is the term WHO uses: in testing, the organism did not respond to that agent. The count is of categories, not of individual drugs.
MDR does not mean that an organism resists every antimicrobial. An MDR organism can still be inhibited by agents outside the categories in which it is non-susceptible, which is why the classification is used to flag a problem for clinicians and laboratories rather than to declare an infection untreatable.
Antimicrobial, antibiotic and multidrug: how the terms differ
Antimicrobial resistance occurs when microorganisms no longer respond to medicines, making infections harder or sometimes impossible to treat. “Antimicrobial” covers agents used against bacteria, viruses, fungi and parasites. “Antibiotic” is narrower and refers to medicines aimed at bacteria. The 2024 joint release from the Food and Agriculture Organization (FAO), the UN Environment Programme (UNEP), WHO and the World Organisation for Animal Health (WOAH) uses the broader AMR terminology. This article uses AMR for the whole problem and MDR for the specific category defined above.
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Why One Health is the organising frame
One Health treats human health, animal health, plant health, food production and ecosystem health as interdependent. WHO’s Regional Office for Europe describes the approach this way: “One Health is an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals and ecosystems.”
The practical reason for the frame is movement. WHO’s regional brief names healthcare facilities, animals, food, soil and water as routes through which resistant organisms can spread. A hospital ward, a poultry farm, a vegetable field and a river can all sit within the same resistance landscape, so controls applied in one sector rarely work alone.
What One Health does not prove
The framework describes connections, not origins. It supports a coordinated response, but it does not establish that a particular resistant infection in a person came from a particular animal, food or environmental source. Resistant organisms do not all move in the same way, and each route needs its own evidence. Treat One Health as a map of possible links that must be tested case by case, not as a single transmission chain.
The 4.95 million figure and the 2030 target
The most-cited number in the 2024 joint release is an estimate of 4.95 million human deaths associated with bacterial antimicrobial resistance annually. The wording is deliberate. “Associated with” marks a link between deaths and bacterial AMR; it is not a finding that resistance alone caused each death. The figure also covers bacterial AMR only, not fungal, viral or parasitic resistance.
The 2024 political declaration set a target of reducing this figure by 10% by 2030. It is a political commitment, not a forecast of what will happen. In the same release, WHO Director-General Dr Tedros Adhanom Ghebreyesus said: “Antimicrobial resistance threatens to unwind that progress, making it without question one of the most pressing health challenges of our time.”
The 2026–2036 Global Action Plan
The World Health Assembly adopted the Global Action Plan on AMR for 2026–2036 at its 79th session in May 2026. WHO describes it as a framework for coordination at global, regional and national levels, with a coordinated One Health response at its centre. It calls for national plans, accountability, monitoring, reporting and sustainable financing.
A plan document circulated as a draft before adoption. Where this article describes specific provisions, it follows WHO’s description of the adopted framework. Check exact wording against WHO’s final published text before quoting it.
What countries are being asked to do
The global commitments group the response into five priorities. Each one applies across sectors.
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Prevent infections and reduce avoidable need for antimicrobials
The 2026 plan names infection prevention and control, safe water, sanitation and hygiene, healthcare waste management, vaccination, and animal husbandry and farm biosecurity. Preventing an infection removes the need to treat it, which is the most direct way to reduce pressure on existing medicines.
Support responsible and equitable use
The plan calls for responsible and sustainable antimicrobial use. The 2024 declaration asks that human antibiotic use prioritise the WHO Access group, a set of antibiotics WHO classifies as first- or second-choice options for common infections. It also calls for prudent, responsible and evidence-based use in animal health. These are commitments for governments and health systems, not prescribing advice for individual patients or animals.
Build connected surveillance
The global plan describes surveillance spanning humans, food-producing animals, food and the environment. Other populations, such as companion animals and wildlife, are added depending on country context and capacity, so coverage differs from one country to another.
Make the data usable and comparable
The plan calls for quality-assured laboratories, shared standards for identifying organisms and testing their antimicrobial susceptibility, reliable diagnostic supply chains, and data sharing across sectors. It says surveillance findings should inform prevention, treatment guidance, stewardship, procurement, research and environmental action. Data that never reach a decision cannot shape any of these.
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Address environmental contamination
The 2024 declaration calls for action on antimicrobial discharges and for more research on environmental dimensions. The 2026 plan describes monitoring AMR organisms and antimicrobial residues to detect hotspots and guide pollution prevention. This is the priority most directly tied to the soil and water routes WHO names.
Independent reader supportYour contribution helps us test, update, and keep practical guides available for everyone.How One Health surveillance is meant to connect data
Surveillance is the mechanism that makes linked action possible. The table shows which sectors the 2026 plan covers and how each relates to the routes WHO names.
| Sector | Route named in WHO’s regional brief | Coverage in the 2026 plan |
|---|---|---|
| Human health and healthcare facilities | Healthcare facilities | Covered (humans) |
| Food-producing animals | Animals | Covered |
| Food | Food | Covered |
| Environment | Soil and water | Covered, including monitoring of AMR organisms and antimicrobial residues to detect hotspots |
| Companion animals | Not named as a separate route in the brief | Added depending on country context and capacity |
| Wildlife | Not named as a separate route in the brief | Added depending on country context and capacity |
The plan names three reporting systems: GLASS, WHO’s system for human resistance and use data; InFARM, FAO’s monitoring system for AMR in animals and food; and ANIMUSE, WOAH’s system for reporting antimicrobial use in animals.
When comparing how a country or institution runs One Health surveillance, check the following:
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- Which sectors are covered, and whether companion animals and wildlife are included
- Whether laboratory methods are consistent and quality-assured
- Whether antimicrobial use data are linked to resistance data
- How representative the sampling is
- Whether data are shared across sectors and used in decisions
- Which prevention measures are in place
- The country’s capacity and context
For methods detail, WHO’s publication Quadripartite guidance on One Health integrated surveillance of antimicrobial resistance and use is available as a print copy through the WHO book shop. WHO’s listing gives an ISBN for the title.
What this means for pet owners
Official frameworks treat animals as one linked group. They name companion animals only as a context-dependent addition to surveillance and do not establish a specific transmission pathway from pets to people. The practical lessons for households are therefore about hygiene, prevention and prudent medicine use.
Prevention at home
- Keep your pet’s routine vaccinations current with your veterinarian. Vaccination is one of the prevention measures named in the global plan, and preventing an infection avoids the need to treat it.
- Wash your hands with soap and water after handling pets, their bowls, bedding, litter or waste, and before eating. This is the hygiene step the plan’s water, sanitation and hygiene priority describes, applied at household scale.
Antimicrobials and your veterinarian
- Give antimicrobials to a pet only when a veterinarian has prescribed them for that animal.
- Ask whether a test to identify the infection and its susceptibility is needed before treatment starts.
- Do not give leftover medicine, or medicine prescribed for another animal or person.
These steps reflect the plan’s emphasis on prudent use in animal health. They are general guidance and do not replace advice from your veterinarian about a specific animal.
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