In the wake of the COVID-19 pandemic, global funding mechanisms for addressing Antimicrobial Resistance (AMR) have come under increasing scrutiny. Historically, AMR efforts have been primarily driven by resource partners from the global North, with limited involvement from policymakers in low- and middle-income countries (LMICs). This donor-dependent approach has proven unsustainable, and the pandemic has underscored the need for a more integrated funding model that combines global and domestic resources.
The Rethinking AMR Mitigation – Mobilizing Resources for Sustainable Impact virtual dialogue was organized by the Platform's Action Group on Advocacy for Impact – Strengthening Sustainable Resource Mobilization in Low and Middle-Income Countries. It brought together a wide range of stakeholders, including governments, industry leaders, civil society, and international organizations, to discuss how to address the challenges of financing AMR mitigation.
A central discussion point focused on the growing threat AMR poses not only to modern medicine but also to broader global health and development goals. The potential loss of effective antimicrobials threatens not only the treatment of infections but also the achievement of Sustainable Development Goals (SDGs). Addressing AMR requires more than just reducing antimicrobial use – it demands significant financial investment, particularly in LMICs. Despite efforts from international resource partners, continued reliance on external funding has proven unsustainable, and the financial strain worsened by the COVID-19 pandemic has further complicated the issue.
Panelists stressed that LMICs must reduce their dependence on external funding and finance their own National Action Plans (NAPs). This shift is critical for ensuring long-term sustainability, as relying solely on resource partners funding leaves countries vulnerable to shifting priorities. In order to prevent disruption to AMR actions, countries must demonstrate the long-term benefits of prevention and diagnostics and make the economic case for investing in AMR interventions.
Another critical point that emerged was the need for a clear guidance on resource allocation based on the prioritization exercise and focus on areas of greatest needs. The current lack of coordination between international funding bodies and national governments has often led to fragmented efforts, limiting the effectiveness of AMR interventions. A coordinated approach combining external support aligned with the national priorities could help streamline efforts and ensure that resources are deployed more effectively.
AMR has been discussed as a public safety concern, rather than solely a medical issue. Like other global challenges such as climate change or the COVID-19 pandemic, AMR must be recognized as a collective global concern that requires ongoing advocacy and widespread awareness. To achieve sustainable impact, individuals must understand their role in both preventing and contributing to AMR, making education and awareness a critical component of any long-term solution.
However, tackling AMR also necessitates addressing its underlying causes, particularly in LMICs. The dialogue emphasized that funding AMR projects in isolation is insufficient. It is crucial to tackle the underlying causes of resistance, such as limited access to preventive tools and inadequate health infrastructure. An example was the inequitable vaccine distribution during the pandemic, that highlighted broader issues of access to essential health services. Addressing these disparities is crucial, not only for preventing AMR, but also for ensuring long-term, sustainable solutions.
Building on lessons learned from the COVID-19 response, participants highlighted several concrete priorities to ensure the momentum generated leads to meaningful change. Among the key recommendations were:
- Adopting a two-year layered approach: Combining emergency planning with system readiness to ensure preparedness for immediate challenges and strengthen long-term resilience to public health emergencies.
- Fostering innovative financing: Leveraging public-private partnerships and international funds to stimulate domestic investment in AMR.
- Integrating AMR into National Health Insurance and broader agendas: Linking AMR efforts with broader health and development policies to ensure sustainable financing and The World Ba:nk's ''Stopping the Grand Pandemic: A Framework for Action'' outlines 20 intervention areas across the One Health spectrum and offers multi-sectoral approaches to optimize resource use, with active dissemination and practical support for implementation.
- Strengthening international collaboration: Enhancing cooperation among the Quadripartite Members (FAO, UNEP, WHO and WOAHP) and other stakeholders to ensure the updated Global Action Plan reflects the LMIC needs and the One Health sectors.
- In conclusion, a unified and coordinated approach is needed, where LMICs are empowered to combine domestic and international funding to strengthen their autonomy, aligning their NAPs with a broader GAP. Central to this effort is raising awareness about AMR – both among the public and within the global agenda – not by making it the sole priority, but by aligning it with existing health and development goals. Funding models for diseases like HIV, TB and Malaria provide a useful framework and it is crucial that any program designed to tackle AMR considers its multi-sectoral nature, giving each sector a role and ensuring a broad, integrated vision.