Antimicrobial resistant pathogens that are detected and reported cause an estimated 700,000 deaths per year.1 The global distribution of antimicrobial resistance (AMR) means that future generations can expect to stay in hospital longer, have increased treatment complications and be at greater risk of dying following surgical procedure.2, 3 The economy will also suffer from escalating healthcare costs and loss of productivity due to excess morbidity and premature mortality.1, 4 An appropriate response relies on accurate data; however, it is becoming increasingly clear that the true burden of infection is significantly greater than what is reported through clinical surveillance data. Indeed, resource-constrained and geographically isolated regions have limited infrastructure, resources and are often outside of surveillance reach. This surveillance blind spot limits health services’ ability to provide early warning signs and response at regional, national and international level. The consequences of delayed disease response are now, more than ever, recognised in the context of the current pandemic.