As more and more strains of bacteria become drug-resistant, scientists are scrambling for ways to adapt and preserve the drugs that save so many lives. But most governments aren't sure quite what to do about the waning efficacy of antibiotics. The World Health Organization recently warned that only a quarter of countries surveyed have plans to preserve antimicrobial medicines, including antibiotics.

The WHO sounded the alarm in conjunction with a new report on how countries worldwide are responding to antimicrobial resistance, James Gallagher reports for the BBC. When they surveyed 133 countries, they found that only 34 have comprehensive plans to preserve the efficacy of antimicrobial drugs like antibiotics. And though monitoring drug-resistant infections and the use of antibiotics is key to controlling future resistance, many countries are hampered by inadequate infrastructure that prevents them from identifying new outbreaks.

The report, which is the first to look at current international efforts to fight antimicrobial resistance, also highlighted the danger of over-the-counter antibiotics. “Weak enforcement of regulations on the sale of antibiotics and other antimicrobial medicines,” presents a particular threat, says the WHO in a release. When antibiotics are too widely available to uninformed consumers, they have the potential to be overused. That, in turn, deepens the danger of drug resistance, an issue the WHO’s Assistant-Director-General for Health Security calls “the single greatest challenge in infectious diseases today.”

But just because some developed nations have a plan, they’re not necessarily safe from the coming crisis. The report points out that public awareness is a problem across the board — for example, many people still think that antibiotics can fight viruses like colds. Though it’s not clear when the public will begin to take antibiotic resistance seriously, one thing is certain: antibiotic use is still prevalent worldwide. In fact, consumption of antibiotics grew 36 percent from 2000 to 2010, with use in the USA outpacing most European countries.