Malak Fouad, a pharmacist in Deir-ez-Zor, discusses local patterns of antibiotic use during a WHO visit. Photo credit: WHO 24 November 2025, Damascus, Syrian Arab Republic – Across Syria, health workers are raising their voices against the growing threat of antimicrobial resistance (AMR). In hospitals, clinics, and community pharmacies, they continue to guide families on the safe use of antibiotics — even as difficult living conditions make responsible use harder to maintain. Their experiences reveal a mix of challenges and determination, and a shared commitment to protect patients from infections that are becoming increasingly difficult to treat.

“Many families still believe antibiotics are the solution for any fever or seasonal cold. Convincing patients about the long-term effects of taking unprescribed medication is becoming increasingly challenging,” says Dr Malak Fouad Kharaba, a laboratory specialist at the National Hospital in Deir-ez-Zor.

Afraa Mawardi, Head of the Drug Control Unit at the National Hospital in Lattakia, at her office, talks about the issue of antibiotic use. Photo credit: WHOShe notes that patient trust, accessible services, and community outreach remain essential to helping people understand when antibiotics are needed — and when they are not.

“With better living conditions, trust, and more awareness of the risks, we can protect patients and save more lives. Awareness campaigns can make a difference, but more effort is needed so that people can protect themselves and those they love,” she adds.

“The issue of antibiotic use is an old and continuing one. Most people understand the risks, but many are forced to seek antibiotics without consulting a doctor because they cannot afford a visit,” explains Afraa Mawardi, pharmacist and Head of the Drug Control Unit at the National Hospital in Lattakia. “We face two main problems — the random use of antibiotics and not completing the prescribed treatment.”

Dr Zein Ali Douba, an oncology specialist in Aleppo, discusses the consequences of antibiotic misuse for patients with weakened immunity. Photo credit: WHO Afraa stresses that ensuring steady availability of medicines and strengthening health centres can help curb misuse. “With continued support to health facilities and ongoing awareness, we can help people get the right treatment at the right time.”

Health workers also note that antibiotic resistance is driven by several interconnected factors beyond individual use. Antibiotics are widely used in livestock and agriculture, and residues can enter the environment through wastewater and soil. Many health facilities face challenges with infection prevention and control, which increases the need for antibiotics and raises the risk of resistant infections. Strengthening these systems through a OneHealth approach — from clean water and waste management to better regulation of agricultural use — is essential to slow the spread of resistance.

In Aleppo, the consequences of antibiotic misuse are especially severe for patients with weakened immunity.

“For oncology and hematology patients, even a minor infection can become dangerous if antibiotics no longer work,” says Dr Zein Ali Douba. “This is why avoiding unnecessary antibiotics — and consulting a doctor before taking any medication — is so important.”

She explains that limited prescription controls and the pressure on health facilities often leave vulnerable patients exposed to inappropriate treatments. “With stronger regulation of antibiotic sales and continued support to health centres, we can help protect patients who face the highest risks of resistant infections.”

For pharmacists like Kamal Al-Dallal in Hama, daily interactions with patients reveal both persistent misconceptions and gradual progress.

“Over the past 15 years, I have seen hundreds of patients who believe antibiotics can cure any infection and that stopping treatment early causes no harm,” he says.

At his pharmacy, many still request antibiotics without a prescription — even for conditions that do not require them. Yet Kamal notes that awareness is slowly improving. “With ongoing awareness efforts and proper training for health workers, we can ensure antibiotics remain effective for everyone who needs them.”

In Homs, frontline clinicians increasingly encounter respiratory infections that do not respond to standard treatments.

“Many patients have respiratory infections resistant to several antibiotics. This makes treatment difficult, lengthy, and sometimes ineffective,” explains Dr Malek Al-Aweer from Homs University Hospital. “Random use of antibiotics — without prescriptions or medical guidance — is a major cause.”

He adds that stronger regulation, more learning in schools and communities, and continuous training for health workers are key steps to reducing misuse. “With collective efforts and support for the health system, we can help people get the right treatment at the right time.”

As Syria joins the World AMR Awareness Week, these voices from across the country highlight a shared concern — and a shared goal: protecting patients, strengthening health systems, and preserving the effectiveness of antibiotics for future generations.

In several governorates, economic hardship continues to push many people to buy antibiotics without medical advice — a long-standing practice that fuels microbial resistance and reduces treatment effectiveness.

Dr Kamal Al-Dallal at his pharmacy in Hama tells of his experience with people who request antibiotics without prescriptions . Photo credit: WHO

In Homs, Dr Malek Al-Aweer reviews a patient chart while standing in the hospital corridor. Photo credit: WHO

23 November 2025, Oslo, Norway – At the Ninth Humanitarian Senior Officials Meeting (SOM) on Syria, WHO highlighted how essential health services can help guide the country’s transition from crisis response to early recovery. Co-hosted by the European Union and Norway, the meeting brought together senior officials from the Syrian authorities, donor governments, UN agencies and humanitarian partners.

WHO’s Public Health Officer Dr Wail Ismail visits a rehabilitation centre where a prosthetics technician supports a young girl during a follow-up check of her artificial limb. Photo credit: WHO

Christina Bethke, WHO Acting Representative to Syria, addressed the session on Syria’s transition toward early recovery. She drew on the Ministry of Health’s two-year strategic roadmap to show how targeted investments can stabilize services and strengthen national systems. The plan focuses on restoring priority facilities, reinforcing the workforce, and improving health financing and information systems.

Primary health centres, referral hospitals and outreach services remain the backbone of care across the country. Reflecting this, Bethke noted that “the facilities keeping people alive today are the same ones that will anchor dignified returns and local recovery tomorrow. If they close now, there is no credible pathway from emergency response to recovery.”

The meeting also underscored the urgent need to support Syria’s health workforce, which has been severely strained by years of conflict and economic hardship. “Infrastructure matters, but without people there is no health system,” Bethke said. “Treating health workers as a long-term national asset is one of the fastest and most practical bridges from relief to recovery.”

WHO and partners are backing labour market assessments, gap-filling in priority facilities, incentives for staff in under-served areas, and new opportunities for training, supervision and twinning with regional entities, while also working to strengthen Syria’s institutional capacity.

Ms. Bethke also highlighted how local health facilities can help communities take their first steps toward recovery. “In many places, the local health centre is one of the first public institutions that people see functioning after conflict,” she said. “When a clinic is safely rehabilitated, has clean water and reliable power, and offers mental health support, antenatal care, safe childbirth and newborn services, it signals that essential services are returning. These improvements help restore trust and support families as they begin rebuilding their lives.”

Across the meeting, partners agreed on the need to protect humanitarian health funding while allowing greater flexibility for early recovery. “Flexible, predictable financing aligned with the Ministry of Health’s two-year plan will allow Syrians to see one coherent offer, rather than competing agendas,” Bethke added.

WHO reaffirmed its commitment to supporting national leadership and strengthening coordination across humanitarian, development, and financial partners. With sustained collaboration, health can help safeguard lives today while laying foundations for stability, dignity, and recovery.

23 November 2025, Aleppo, Syrian Arab Republic – At Al-Bab Health Centre in eastern Aleppo, routine growth monitoring offers families reassurance that their children are developing well. For Mona Talrafadi, who visited the centre with her mother, the checkup confirmed she was healthy and thriving.

Community health worker Dumoo’ checks Mona Talrafadi’s height as part of regular growth monitoring at Al-Bab Health Centre in eastern Aleppo. Photo credit: WHO

Inside the community health section, community health worker Dumoo’ welcomed Mona and her mother with a gentle smile. She measured Mona’s height, weight and mid-upper arm circumference — simple but essential assessments that help detect early signs of malnutrition. All of Mona’s measurements were within normal ranges.

“We focus on catching any issues early,” says Dumoo’. “A few minutes of checking can prevent months of worry for a family. These visits help us understand how children are growing and whether they need extra support.”

After documenting the results, Dumoo’ sat with Mona’s mother to discuss healthy feeding practices, hydration, and the importance of regular follow-up appointments. “A lot of mothers tell us they feel overwhelmed,” she explains. “So we always try to give advice that is simple, practical, and fits their daily lives.”

For Dumoo’, the connection with parents matters as much as the measurements. “When a mother leaves here feeling more confident, that is success for us,” she says. “They trust us, and we want them to know we are always here to listen.”

A close view of a mid-upper arm circumference measurement taken during Mona’s health assessment. Photo credit: WHO

Mona’s mother agreed. “They explained everything clearly,” she says. “These visits help me feel confident about how to care for her.”

The services at Al-Bab Health Centre are delivered in coordination with the Ministry of Health and implemented on the ground through Alameen Organization, whose teams ensure essential health care remains available to communities with limited options.

Dumoo’ measures Mona Talrafadi’s mid-upper arm circumference during a routine growth-monitoring. Photo credit: WHO

Since late 2024, continued support from the King Salman Humanitarian Aid and Relief Centre (KSrelief) has helped WHO keep 50 health facilities operational across northwest Syria, including Al-Bab. This contribution has ensured uninterrupted access to primary, secondary, and specialized services – from essential medicines and supplies to dialysis care, which remains a growing need in the region.