Why the fight against non-communicable diseases means confronting drug resistance

Medicine has made remarkable gains against non-communicable diseases, particularly cancer, cardiovascular disease and diabetes. Yet an often-invisible threat could undermine this progress: antimicrobial resistance – the rise of drug-resistant bacteria, viruses and fungi.

Protecting gains against non-communicable diseases means confronting antimicrobial resistance.

On 25 September 2025, member states will meet at the UN "High-Level Meeting on the Prevention of Noncommunicable Diseases and Mental Health" to reaffirm cutting premature non-communicable disease mortality by one-third by 2030.

Achieving this target requires recognizing that non-communicable diseases and antimicrobial resistance are interconnected challenges. Given the importance of this issue, the World Economic Forum Global Future Council (GFC) on Antimicrobial Resistance outlines what's at stake and what is needed now.

According to a draft political declaration, member states demand “integrated strategies that safeguard the effectiveness of antimicrobials across health systems” and coordinated action through multisectoral partnerships.

The combined challenges of antimicrobial resistance and non-communicable diseases place a heavy burden on vulnerable populations in low-, middle- and high-income countries, where such diseases are more prevalent.

Our modern world rests on our ability to manage infectious diseases. For most of history, infections have been the leading cause of death globally.

Over the last 100 years, vaccines, sanitation and antimicrobials have drastically reduced the impact of infections and facilitated the treatment of non-communicable diseases, with antibiotics contributing to a 23-year rise in life expectancy.

In 2021, non-communicable diseases accounted for most global deaths, while antibiotic resistance was linked to 4.71 million deaths, with 1.14 million directly attributable to it. These two leading concerns are intertwined: antimicrobial resistance undermines the effectiveness of many disease treatments.

Evidence shows that patients with non-communicable diseases are at higher risk of resistant infections, while attention given to their interaction remains limited. In a UK survey of 100 oncologists, for example, 46% feared chemotherapy could become unsafe or infeasible because of antimicrobial resistance.

Cancer patients are nearly three times more likely to die from infection and in hospitals, cancer patients are up to twice as likely to contract a drug-resistant infection. One study found that after pancreatic cancer surgery, about 64% of infections were resistant to standard antibiotics.

More than half of diabetic foot wounds carry multidrug-resistant bacteria and patients with complicated diabetes are 54% more likely to get resistant infections.

Cancer treatments, dialysis, surgery and transplantation for many non-communicable diseases depend on a shrinking arsenal of effective antimicrobials, with fungal and other pathogens playing an under-recognized role.

Resistant infections occur in up to 73.8% of solid-organ transplant recipients across liver, kidney and lung transplants and infections from cardiac implants have risen by over 200%, alongside growing multidrug resistance.

Understanding the intersection between non-communicable diseases and antimicrobial resistance requires an understanding of the lived experiences of patients. The patient’s condition and its associated risks are not lived as separate issues but as one continuous journey. Our approach to care should reflect this.

Patients with non-communicable diseases may face a self-reinforcing cycle: weakened immunity, longer hospital stays and invasive procedures, all of which raise their risk of infections, particularly drug-resistant ones.

Additionally, antimicrobial resistance-related complications and prolonged care increase costs for patients and health systems and impose a significant mental health burden on patients and caregivers.

To fulfil the objectives of the high-level meeting on non-communicable diseases, member states aim to reshape and strengthen health systems and financing.

Achieving this requires a holistic approach to antimicrobial resistance, guided by the steps outlined in the UN General Assembly 2024 Political Declaration of the High-level Meeting on Antimicrobial Resistance: new, flexible and cross-issue financing models, innovation, improved access to antimicrobials and stronger infection-prevention strategies.

Effective action depends on creating financial mechanisms that align public and private interests and support responses to non-communicable diseases and antimicrobial resistance as an integrated challenge. To that end, mobilizing resources requires going beyond public investment and developing new ways to unlock private sector engagement.

The private sector, including pharmaceuticals, diagnostics, digital health, insurance, food production and fintech, has the capacity but not the right incentives to drive sustainable solutions.

For this integrated response to succeed, it must be embedded within the broader framework of universal health coverage, which ensures access to essential health services without financial hardship.

In low- and middle-income and some high-income countries, many people are uninsured and seek care from informal drug sellers and local pharmacies, so strategies must also include these providers.

Across all healthcare delivery, antimicrobial stewardship drives the use of appropriate diagnostics and prudent antimicrobial use, thereby reducing resistance, improving patient safety and lowering extended-care costs.

Stewardship should be seen not only as the responsibility of microbiology and infectious disease specialists but as a core duty of all healthcare professions and specialists.

Yet current stewardship and targeted diagnostic approaches at the interface of antimicrobial resistance and non-communicable diseases are inconsistent and insufficient to deliver effective and timely care.

Alongside stewardship, vaccinations, water, sanitation and hygiene and infection prevention and control are essential to limit the spread of drug-resistant infections and reduce infection-related complications in treatment.

At the institutional level, tackling non-communicable diseases and infectious diseases demands breaking down silos between stakeholders. Public health agencies, the private sector and civil society must rally around infection prevention and control.

The silos are not limited to human health.

The joint fight against non-communicable diseases and antimicrobial resistance must be situated within the broader One Health framework, adopting a holistic approach that encompasses human, animal and environmental health to address shared drivers.

For example, optimizing food production and supply chains can reduce antibiotic use, curb antimicrobial resistance and promote lifestyle changes that prevent and reverse diabetes and other non-communicable diseases. Such alliances are especially important in low- and middle-income countries, where access to quality healthcare is limited.

Progress depends on bringing integrated prevention, diagnostics, and treatment closer to communities through primary care, digital health, and innovative financing under universal health coverage. This is only possible through the support of committed leadership across sectors and a strong political will.

Solving antimicrobial resistance and mitigating its impact on non-communicable diseases requires investment in new and existing vaccines, diagnostics and therapeutics, strengthening health systems that balance access with stewardship and reforming food systems to reduce reliance on antimicrobials.

Without addressing antimicrobial resistance, advancements in the management of non-communicable diseases will not be possible.

This agenda blog was written with the contribution of the Co-Council Manager of the GFC on Antimicrobial Resistance, Matteo Consiglio.

The GFC on AMR is a part of the Unified Coalition for the Antimicrobial Resistance Response (UCARE) Initiative for the Centre of Health and Health Care.