Antimicrobial resistance and NCCPs

Key Messages

Antimicrobial resistance (AMR) poses a profound and growing threat to global health, with particularly severe implications for cancer care.
AMR was associated with 4.95 million deaths in 2019 and a reported 1.27 million people died as a direct result of drug-resistant infections.
AMR will reduce life expectancy globally by 1.8 years over the next decade without proper action.
People living with cancer are especially vulnerable to infections due to immunosuppression caused by treatments such as chemotherapy, radiotherapy, and surgery.
Infections are now the second leading cause of death among cancer patients - many of which are increasingly resistant to standard antimicrobial treatments.
Without effective antimicrobials (like antibiotics and antifungals), even routine infections can become life-threatening, undermining decades of progress in cancer treatment and care.

Despite this, AMR is rarely addressed in NCCPs.

People with cancer face up to three times the risk of drug-resistant infections.
with certain specific pathogens that can cause life-threatening infections, such as bloodstream infections or occurring after surgery or chemotherapy, the risk of AMR infections was up to five times higher among cancer patients.
Infections (especially drug-resistant infections) can lead to the delay or interruption of cancer treatments.
Patients with blood-related cancers (haematological malignancies) have higher mortality rates when affected by drug-resistant infections.

Integrating AMR strategies into NCCPs is critical for effective cancer control.
As NCCPs provide governments with the strategic tools needed to improve cancer prevention, treatment, and care, their scope must reflect emerging threats like AMR.
Including AMR in these plans ensures a coordinated approach to infection prevention and control (IPC), antimicrobial stewardship (AMS), and access to essential antimicrobials and diagnostics. These components are critical to safeguarding cancer patients from drug-resistant infections and ensuring continuity of care.
Aligning NCCPs with national AMR action plans can foster multisectoral collaboration, optimise resource use, and strengthen health system resilience. As the burden of AMR grows, its integration into NCCPs is a necessary step to protect cancer patients and preserve the effectiveness of life-saving treatments.

Cancer planners are not starting from scratch. A growing body of resources is available to support the integration of AMR into NCCPs. These include WHO guidance on infection prevention and control, antimicrobial stewardship toolkits tailored for low- and middle-income countries, and the WHO Model Lists of Essential Medicines and In Vitro Diagnostics. Additionally, platforms such as the International Cancer Control Partnership (ICCP) portal offer access to global reviews, policy templates, and examples of best practices. Leveraging these tools can help planners embed AMR strategies into cancer control frameworks in a practical, evidence-based, and context-specific manner.

Library of National Action plans- Library of national action plans
Global Leader’s Report on AMR. glg-report-final (14).pdf
World Health Organization. Guidelines on Core Components of Infection Prevention and Control Programmes at the National and Acute Health Care Facility Level. WHO. 2016. [cited 2025 March 01].Available from: 9789241549929-eng.pdf
World Health Organization. Antimicrobial stewardship programmes in health-care facilities in low-and middle-income countries: a WHO practical toolkit. Geneva: WHO; 2019. [cited 2025 March 01]. Available from: 9789241515481-eng.pdf
The WHO AWaRe (Access, Watch, Reserve) antibiotic book. The WHO AWaRe (Access, Watch, Reserve) antibiotic book - Infographics
Resistance beyond antibiotics – antifungal resistance. 89-91.pdf

The Novo Nordisk Foundation has supported this page by grant number: NNF24SA0101658