At the recent United Nations General Assembly in New York, all countries approved a major new political declaration to radically scale up efforts to combat antimicrobial resistance (AMR) - a major threat to modern medicine.AMR threatens to unwind a century of medical progress, and could return us to the pre-antibiotic era, where infections that are treatable today could become much harder to treat and grow potentially deadly tomorrow.

AMR is caused largely by the misuse and overuse of antimicrobial medicines - such as antibiotics - making microbes resistant to them, and diseases more dangerous and deadly.

It's an issue with implications for health at large. Medical facilities are often where the most stubbornly treatment-resistant infections emerge and spread. AMR makes all manner of routine health procedures riskier; in low- and middle-income countries (LMICs), approximately 11 percent of people who undergo surgery are infected in the process.

The burden of treatment-resistant infections falls heaviest on LMICs, where AMR is worsened by a lack of access to clean water, stretched health systems, limited budgets, poor access to diagnosis and appropriate treatment, and a lack of enforcement of legislation. Sepsis in newborns that spreads in hospitals is a particularly dramatic illustration of how tough the situation is in LMICs.

The crisis in equitable access to new and existing antimicrobial medicines is also felt most acutely in LMICs, where a lack of availa ...