Poor access to reliable diagnostic testing can make it harder to choose the right treatment for an infection—and harder for health systems to see where antibiotic resistance is spreading. Better diagnostics are an important part of the response, but they are not a cure on their own: responsible antibiotic use, infection prevention, access to appropriate medicines, and dependable surveillance also matter.
How can poor diagnostics contribute to antibiotic resistance?
When clinicians cannot establish what is causing an illness, they may have to make treatment decisions with incomplete information. Tests can help distinguish infection types and guide whether an antibiotic is appropriate and which treatment to use. Without timely, reliable results, treatment may be empirical—chosen before the cause is known—and may be wrong or unnecessary.
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That is a risk, not a claim that every prescription made without a test is inappropriate. The effect depends on the illness, the available clinical information, and whether a useful test can be obtained and acted on. The UK Government’s 2019–2024 action plan described the problem in its period: most antibiotic prescribing, supply, and administration occurred without information about the nature of the infection. It cited limited access to quick, reliable, affordable tests, particularly in low- and middle-income countries, as well as weak use of tests that were available.
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The plan said that tests for most bacterial infections took approximately 48 hours to yield results at the time. That is a historical, UK-plan-era assessment—not a current universal turnaround time. Delayed results can make testing less useful for an immediate decision, while unreliable or inaccessible tests may not provide a sound basis for one.
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What do resistance figures show—and what do they not show?
WHO’s 2025 surveillance release reports substantial resistance among the infections included in its monitoring. These figures describe laboratory-confirmed infections and reported surveillance data; they are not estimates for every infection worldwide.
| WHO-reported finding | Scope and qualification |
|---|---|
| One in six infections were resistant to antibiotic treatment | Laboratory-confirmed bacterial infections causing common infections worldwide in 2023, as reported by WHO in 2025. |
| One in three reported infections were resistant | Reported infections in the South-East Asian and Eastern Mediterranean Regions in 2023, summarized by WHO in 2025. |
| One in five reported infections were resistant | Reported infections in the African Region in 2023, summarized by WHO in 2025. |
| Resistance rose in over 40% of monitored pathogen–antibiotic combinations | WHO reported this trend for 2018–2023, with an average annual increase of 5–15% across the combinations concerned. |
WHO says resistance is more common and worsening where health systems lack capacity to diagnose or treat bacterial pathogens. The surveillance findings show why those gaps matter, but they do not quantify how much improving diagnostic access alone would change resistance rates. Diagnostics are one part of a broader health-system response.
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Why testing matters beyond an individual prescription
Laboratory testing has two connected roles. For a patient, it can help clinicians make better-informed treatment decisions. For a health system, test results can support antibiotic stewardship, infection prevention, outbreak investigation, and surveillance of resistance. If results are incomplete, unreliable, or concentrated in a few places, public-health teams have a less dependable picture of what is circulating and where.
WHO’s 2025 release illustrates the surveillance challenge. Participation in its Global Antimicrobial Resistance and Use Surveillance System (GLASS) grew from 25 countries in 2016 to 104 in 2023. Yet 48% of countries did not report data to GLASS in 2023, and about half of reporting countries lacked systems to generate reliable data. Reporting participation is therefore not the same as having strong, representative laboratory capacity.
WHO emphasizes the need for reliable data, particularly from underserved areas, so surveillance can inform treatment and policy. Better coverage and laboratory capacity can make resistance patterns more visible; they do not by themselves guarantee that clinicians have timely results or that the findings lead to effective action.
What is WHO doing to strengthen diagnostics?
WHO’s AMR Diagnostic Initiative builds on the 2023 World Health Assembly resolution WHA76.5 on strengthening diagnostic capacity. Its aim is equitable access to quality testing across health systems and in communities, alongside stronger bacteriology and mycology laboratory services. WHO describes the initiative’s goal as bringing diagnostics “to the forefront of the global AMR response” and supporting quality testing for bacterial, fungal, and resistant pathogens.
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The initiative sets out four building blocks:
- A strategic and operational framework for laboratory services.
- Standardized tools to assess laboratory capacity.
- A Global AMR Laboratory Network to strengthen coordination and capacity.
- Research and innovation to improve diagnostic precision, speed, and usability.
Together, these priorities address more than the availability of a test. Testing must be accessible, produce dependable results, and fit the needs of the people and health services expected to use it.
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Why better tests must be paired with stewardship
A diagnostic result can inform a decision, but appropriate antibiotic use also depends on clinical practice, medicine access, infection prevention, and health-system support. WHO identifies antibiotic misuse and overuse as major drivers of antimicrobial resistance. Its 2026 fact sheet says Access antibiotics accounted for 53% of global human antibiotic use in 2022, below the 2030 target of at least 70%. “Access” is a WHO antibiotic classification; the figure does not mean that all other antibiotics were necessarily misused.
WHO Director-General Tedros Adhanom Ghebreyesus put the connected priorities this way in an October 2025 release: “As countries strengthen their AMR surveillance systems, we must use antibiotics responsibly, and make sure everyone has access to the right medicines, quality-assured diagnostics, and vaccines.” Diagnostics can support those goals, but improvements in testing need to be matched by the capacity to interpret and act on results.
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