Antimicrobial resistance (AMR) is no longer a future threat; it is a present and accelerating global health emergency. Already, AMR contributes to the deaths of an estimated 5 million people worldwide each year, and current trajectories indicate exponential growth over the coming decades. If left unchecked, AMR represents a more immediate threat to human life than climate change.
At the sharp end of this crisis sits sepsis – the final common pathway to death from most infectious diseases globally. Sepsis is responsible for around 20 million deaths annually, accounting for one in five deaths worldwide. Today, survival rates from sepsis in well-resourced systems may approach 70%. As AMR advances, those survival rates are projected to fall to as low as 20%. This would not simply overwhelm health systems; it would fundamentally alter human population trajectories, shifting us from population growth toward population decline.
The economic consequences are equally stark. In the UK alone, AMR and sepsis are estimated to cost more than £20 billion each year, through healthcare expenditure, lost productivity, and wider societal impact. Yet despite these figures, our collective response remains fragmented and overly dependent on outdated models of care.
Why incremental change is no longer enough
For decades, the dominant response to infection has been hospital-centric and antimicrobial-heavy. While antibiotics remain lifesaving and indispensable, our over-reliance on them – combined with late diagnosis and reactive care – has driven resistance and avoidable harm.
The solution to AMR will not come from the antimicrobial pipeline alone. Even with new drugs, resistance will inevitably follow unless we transform how, where, and when we diagnose and treat infection.
This is where not-for-profit leadership, system convening, and public-interest innovation become critical.
From hospitals to homes: a new model of care
We now have the tools to rethink infection management at a societal level. Wearable technologies, point-of-care diagnostics, digital decision support, and data-driven risk stratification mean that many people with suspected infection can be safely assessed, monitored, and cared for in their homes and communities.
With confidence in diagnosis, we can:
- Safely withhold antimicrobials in patients at very low risk of bacterial infection
- Intervene earlier for those at genuine risk of deterioration
- Reduce unnecessary hospital admissions, which themselves increase infection risk
- Preserve antibiotics for when they are truly needed This shift aligns directly with the mission of purpose-driven organisations working at the intersection of prevention, community health, and innovation. Moving care closer to home is not just more humane; it is essential to protecting antimicrobials as a shared global resource.
Precision medicine, powered by data
AMR demands that we move beyond population-level assumptions toward precision medicine. The question is no longer “does this patient have an infection?” but rather:
- Is it bacterial or viral?
- What is their individual risk of sepsis?
- Will antimicrobials help – or cause harm? Integrating novel diagnostics into community, rural, and underserved settings is therefore of utmost importance. Data-driven approaches can support clinicians, empower patients, and ensure equitable access to safe decision-making, regardless of postcode.
Not-for-profits have a unique role here: convening health systems, innovators, policymakers, and communities to ensure these technologies are deployed ethically, equitably, and at scale, rather than widening existing inequalities.
AMR as a One Health challenge
AMR does not respect sectoral boundaries. A credible response must embrace a One Health approach, recognising the interconnectedness of human health, animal health, and the environment.
This includes:
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Antimicrobial use in agriculture and horticulture
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Environmental contamination from pharmaceutical manufacturing
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Hospital waste disposal and water system contamination
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The broader ecological impact of resistant organisms Irresponsible practices in any one domain undermine progress in all others. Addressing this requires cross-sector collaboration, public accountability, and systems leadership – areas where mission-led organisations can act as trusted brokers and catalysts for change.
A call to collective action
AMR and sepsis are immediate existential threats, not distant hypotheticals. Yet they are also solvable – if we are willing to rethink how we organise care, invest in prevention, and place people and communities at the centre of the solution.
Not-for-profits committed to health, wellbeing, and social value have a vital role to play:
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Championing early diagnosis and prevention
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Supporting community-based models of care
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Aligning innovation with public good, not short-term profit
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Advocating for system-wide change grounded in evidence and equity The choices we make in the next decade will determine whether antimicrobials remain one of medicine’s greatest achievements – or become a symbol of missed opportunity. The time for transformational change is now.