Background The Commonwealth Medical Association (CMA) is a non-governmental organization established in 1962 to assist and strengthen the capacities of National Medical Associations across the Commonwealth countries. The CMA represents medical professionals from 56 Commonwealth nations. This consensus statement, ‘The London Resolution on Antimicrobial Resistance — 2025’ was developed by the Commonwealth Alliance of Medical Professionals on Antimicrobial Resistance (CAMP AMR). This global alliance was officially launched on November 9, 2024, during the 27th Biennial Conference of the CMA held in Chennai, India. CAMP AMR serves as a strategic unified front, bringing together expertise from across the Commonwealth to implement evidence-based solutions — such as the Indian Medical Association (IMA) AMR SMART Hospital — to halt the spread of antimicrobial resistance and ensure that life-saving antimicrobials remain effective for future generations. The London Resolution was formulated through a systematic process that involved drafting actionable protocols based on established evidence-based models. This initial framework was subjected to rigorous consultation cycles, where draft versions were shared with the National Medical Associations of all member states to gather regional feedback and ensure operational feasibility across diverse healthcare settings. Consensus was finalised through a formal deliberative session in London on July 18, 2025, where representatives from across the Commonwealth reviewed and unanimously adopted the final 14 commitments. This collaborative approach ensured that the mandate was not only scientifically robust but also reflected a unified political and professional will to address the AMR crisis collectively. Preamble 1. We, the representatives of National Medical Associations from 56 countries across the Commonwealth, convened in London, United Kingdom, during the Annual Meeting of the Commonwealth Medical Association on 18th July 2025, solemnly acknowledge the intensifying threat posed by Antimicrobial Resistance (AMR) to global health and sustainable development. 2. This London Declaration on AMR affirms our collective resolve to confront AMR through unified, multisectoral actions grounded in the principles of One Health and aligned with the Sustainable Development Goals. We urgently call upon National Medical Associations, Governments, healthcare professionals, civil society organisations and international agencies across the Commonwealth to collaborate in advancing sustainable, evidence-based solutions, including antimicrobial stewardship, infection prevention and control and responsible use of antimicrobials – ensuring the health and well-being of current and future generations. Recognition of Antimicrobial Resistance Crisis 3. AMR has emerged as a grave and accelerating global health threat, undermining the efficacy of life-saving interventions and contributing to increasing morbidity and mortality worldwide. Declared a ‘silent pandemic’ by the World Health Organization (WHO), AMR requires urgent and coordinated global action.1 4. The global burden of AMR is staggering. In 2021 alone, an estimated 4.71 million deaths were associated with bacterial AMR, with 1.14 million deaths directly attributable to bacterial AMR.2 The human cost is profound – prolonging illness, increasing patient suffering and exacerbating health inequalities. 5. AMR places a tremendous economic strain on health systems and national economies. According to World Bank estimates, AMR could cost the global economy an additional USD 1 trillion in healthcare expenditures by 2050, with projected GDP losses between USD 1–3.4 trillion annually by 2030 due to reduced productivity, increased treatment costs and prolonged hospitalisations.3 6. We acknowledge that AMR challenges the progress of modern medicine, compromising essential treatments, such as surgical procedures and infection management. This rollback of medical advancements not only risks current health outcomes but also threatens future innovations and resilience in healthcare. 7. The AMR threat is multidimensional – impacting human and animal health, agriculture, food systems and the environment. It disproportionately affects vulnerable populations, including children, the elderly and immunocompromised individuals, thereby raising critical issues of health equity, social justice and planetary health. 8. Addressing AMR demands a concerted One Health approach, with strengthened coordination at local, national, regional and global levels. Multisectoral governance, Public–private partnerships and collaborative innovation are essential to building resilient, AMR-responsive health systems. London Resolution on AMR 2025: Call to Action In pursuit of our collective vision to halt the spread of AMR, we hereby resolve to: 9. Designate an AMR Focal Point within 30 days in each National Medical Association to liaise with the Commonwealth Medical Association and coordinate Commonwealth-wide AMR initiatives. 10. Establish a Standing Committee on AMR under each National Medical Association within 3 months, ensuring inclusive representation, including junior doctors and medical students. 11. Prioritise AMR and IPC (Infection Prevention and Control) as flagship themes in all National Medical Associations. The Standing Committee and the Commonwealth Alliance of Medical Professionals on AMR (CAMP AMR) must be prominently featured on each Association’s official platforms (including websites) within 3 months. 12. Form formal multisectoral partnerships with veterinary, agricultural and environmental sectors within 6 months to operationalise the One Health strategy at national levels. 13. Advocate for the integration of AMR and IPC education into undergraduate and postgraduate medical curricula in all Commonwealth countries. 14. Allocate at least one session on AMR in the upcoming National Annual Conference of each National Medical Association and continue this annually. 15. Coordinate a Commonwealth-wide observance of World AMR Awareness Week from November 2025 onwards, engaging health workers, pharmacists, nurses, doctors, paramedics and the public in awareness and advocacy. 16. Encourage the National Medical Associations to promote the publication of at least one AMR-related article per issue in the respective National Medical Association’s Journal. 17. Convene CAMP AMR members biannually, leveraging virtual platforms, to review progress, exchange best practices and strategise next steps. 18. Promote the IMA AMR SMART Hospital Model, with each country identifying at least 10 hospitals within a year to serve as national role models for antimicrobial stewardship and infection control. 19. Support the development of the CMA Fellowship in AMR within the next 3 months and encourage enrolment of clinicians and public health professionals across member countries. 20. Collaborate with national authorities to strengthen systems for the safe disposal of expired and unused antimicrobials from households, thereby reducing environmental contamination and preventing environmental AMR transmission. 21. Establish formal collaboration with respective WHO Country Offices to seek technical support, capacity-building assistance and alignment with national AMR action plans. 22. Engage with national governments to secure dedicated financial allocations for AMR activities, including capacity building, research and innovation, within a 6-month timeline. Mobilise Corporate Social Responsibility funding, aligning private sector investments with national and Commonwealth-wide AMR priorities. Conclusion 23. We, the representatives of the National Medical Associations of the Commonwealth, reaffirm our unwavering commitment to this London Declaration on AMR. Recognising AMR as one of the defining global health challenges of our time, we pledge to act with urgency, unity and ambition – guided by the principles of One Health and the Sustainable Development Goals – to halt the spread of antimicrobial resistance and safeguard the health of populations across the Commonwealth. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest. Peer review Not commissioned. Externally peer reviewed in double blinded approach.
Karthikeyan et al. (Sun,) studied this question.