Dr Santosh Pokhrel examining Raju Dasji during his morning rounds in a general ward at the Nepal Korea Friendship Municipality Hospital in Bhaktapur, Nepal. Dasji was suffering from pneumonia, kidney disease and a partially antibiotic-resistant Escherichia coli infection.

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AMR in Nepal: Our capacity to heal is in danger

Nyani Quarmyne | Nepal

According to WHO Director-General Tedros, antimicrobial resistance (AMR)—the evolved ability of pathogens to withstand antibiotics and other treatments—could “roll back a century of medical progress”. In 2019 at least 1.27 million deaths resulted from drug-resistant infections, more than from HIV or malaria. Yet the urgency of the situation is not reflected in health policy and budgets.

AMR is driven predominantly by the misuse of antibiotics:

  • over-prescription, self-medication and overuse in agriculture create conditions for bacteria to evolve resistance
  • antibiotic residues in wastewater flow into watercourses
  • residues perfuse crop soils; ultimately people and animals consume them, furthering resistance
  • throughout, bacteria exchange genes for resistance; even beneficial bacteria in our bodies may develop and transfer resistance to harmful bacteria

Nepal is recognising, as we all should, that a holistic ‘One Health’ approach is needed: we must see the wellbeing of humans, animals and environment as intrinsically connected.

Nepal and the Southeast Asian region have become an AMR hotspot, partly due to rapid development and urbanisation. Nonetheless, Nepal serves here only as one example of what is a global problem.

I worked on this story with journalist Laura Salm-Reifferscheidt. Our reporting was supported by the European Journalism Centre under their 2023 Global Health Security Grant Program.

Nyani Quarmyne



+49 162 578 4064

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