INTRODUCTION: Antimicrobial resistance (AMR) has shifted from a projected threat to a measurable global crisis, with recent surveillance showing rising resistance across major pathogen - drug combinations. This perspective examines why resistance is accelerating despite years of global action. AREAS COVERED: Drawing on an exploratory search of PubMed, Scopus, Google Scholar, and key WHO and CDC reports, we synthesized peer-reviewed studies and surveillance reports published up to October 2025. We focus on five interlinked failures: fragmented surveillance, inappropriate antibiotic use in human and animal sectors, environmental amplification of resistance, stagnation in antibiotic innovation, and inequities in diagnostic and treatment capacity. Available estimates indicate that around 90% of AMR deaths occur in low- and middle-income countries, while livestock consume most antibiotics used globally. Headline surveillance figures are largely based on laboratory-confirmed infections and uneven country reporting, and therefore should not be interpreted as true population incidence. EXPERT OPINION: .
Gulumbe et al. (2026) studied this question.