Economics of AMR

The ability to take action on AMR depends on a clear understanding of how AMR compares to other competing, often pressing priorities. A key focus on the QJS is therefore to better understand the full economic implications of AMR today and in the decades to come, and to support governments and health authorities around the globe better understand what is at stake.  

As part of this work the technical team is aggregating and extrapolating cost and burden data, in an effort to predict the overall economic losses that can be expected from continuing with the current level of AMR-combatting activity – i.e. the Cost of Business as Usual. The second component of this work involves estimating the Return on Investment that can be expected from implementing a set of key interventions, e.g. antimicrobial stewardship, surveillance, wastewater treatment, etc. across the different One Health settings (human health, animal health and agriculture, and the environment) at suitably high levels of coverage globally. Together these analyses are intended to support global leaders allocating resources across different areas.   

A Toolbox is also being created to support decision-makers at national level better internalize the phenomenon of AMR and its economic implications, and choose optimal interventions given the national and sub-national epidemiological and financial context. In being better able to predict their own economic losses from AMR and foresee how to hedge against such losses through targeted interventions, country leaders will be better placed to make internal resource allocation decisions and justify requests for external funded where it is needed to support such action.  

Integrated Surveillance

• Integrated One Health surveillance of antimicrobial resistance and use (AMR and AMU) across all sectors is a key priority for the GLG and the Quadripartite organizations.
• The Quadripartite has established a Quadripartite Technical Group on Integrated AMR and AMU Integrated Surveillance to provide advice and guidance on the development of global and context-appropriate regional and country-level systems for integrated surveillance and the establishment of effective capacities. The Quadripartite Technical Group on Integrated Surveillance comprises 28 AMR and AMU surveillance experts across sectors. 
• The GLG has also established a task force on integrated surveillance with the focus on defining key issues for advocacy and to advise on integrated AMR/AMU/AMC One Health surveillance; to take forward high-level evidence-based advocacy for this critical area of focus at national and international levels; and to strengthen communication across sectors and between stakeholders, politicians, and scientists.

Updates for Quadripartite technical actions and GLG advocacy actions on integrated surveillance

The Quadripartite Technical Group has developed and agreed on an action plan for 2022-2024 and developed a list of priority outputs to be included in the Quadripartite Guide on Integrated Surveillance. These outputs will be developed given the UNGA HLM on AMR in 2024 and for ongoing advocacy for integrated surveillance of AMR and AMU across One Health sectors. These include:

Purpose-led definition of One Health integrated surveillance of AMR and AMU

Priority measures and indicators for One Health integrated surveillance of AMR and AMU

Resources and requirements for the different purposes One Health integrated surveillance of AMR and AMU

Harmonized framework for the establishment of integrated surveillance systems.

The Technical Group will aim to finalize components of the Quadripartite Guide that will require QJS SMG approval between October and January 2024 and has organized into working groups to drive the delivery of these components.

• The GLG Taskforce on Integrated Surveillance is developing a Pocket Guide on Integrated Surveillance for Political Decision-Makers to show the need for and identify actions to support integrated surveillance of AMR and AMU across sectors. The pocket guide will align with the work of the Quadripartite Technical Group. The GLG will continue to advocate for and facilitate essential dialogues on building sustainable surveillance capacity and infrastructure and seek opportunities created by the Covid-19 pandemic to strengthen AMR and AMU surveillance.

Monitoring and Evaluation

The monitoring and evaluation (M&E) teams of the Tripartite have been collaborating effectively since 2016 to monitor the implementation of the global action plan on AMR (GAP-AMR) as well as the implementation of the national action plans on AMR (NAP-AMR).  Since 2016 they have also jointly developed and administered the annual “Tripartite AMR Country Self-assessment Survey” (TrACSS) to collect country-level AMR data from all sectors. Staff from the headquarters, regional offices and country offices have all been engaged in the administration of this survey.  In 2022, with the addition of UNEP to the partnership, the survey was renamed as “Tracking AMR Country Self-assessment Survey.” Seven rounds of the survey have been administered and all the results have been published on a public website, www.amrcountryprogress.org. The results of the survey have also been launched through a Quadripartite global webinar and widely disseminated. In 2023 a record 177 countries responded to the TrACSS.

Members of the Tripartite monitoring and evaluation teams developed and published the global monitoring and evaluation (M&E) framework for the GAP-AMR in 2019.  The global monitoring and evaluation framework was designed to facilitate the assessment of GAP-AMR implementation at the national and global levels. It provides a recommended list of indicators. The M&E teams tested these indicators and the framework in many low-and middle-income countries successfully.  In addition, the Quadripartite M&E teams, supported by a global grant from the MPTF, provide targeted technical assistance to countries to conduct assessments, and establish and implement monitoring plans for their AMR NAPs. In 2023, a M&E country guidance document was produced by the Quadripartite to assist countries in establishing their M&E framework for their AMR-NAPs.

The GAP-AMR committed the Tripartite to producing biennial reports on national and global progress in addressing AMR. A report was produced by the Tripartite monitoring and evaluation teams in 2019 and was incorporated into a report of the United Nations Secretary-General as “ Follow-up to the political declaration of the high-level meeting of the General Assembly on antimicrobial resistance.”  The Quadripartite have now jointly developed a biennial report with country level data from 2020-2021, relevant GAP M&E indicators data, and relevant information up to 2022; this report could also include data from 2023 after analysis is completed.

Tracking AMR Country Self-assessment Survey (TrACSS)

The Global Action Plan on Antimicrobial Resistance (AMR) was adopted in 2015 by all countries through decisions in the World Health Assembly, the Food and Agriculture Organization of the United Nations (FAO) Governing Conference and the World Assembly of World Organisation for Animal Health (WOAH, founded as OIE) Delegates. Countries agreed to have a national action plan on AMR that is consistent with the Global Action Plan, and to implement relevant policies and plans to prevent, control, and monitor AMR.

To monitor country progress in the implementation of their national actions plans, an annual AMR country self-assessment survey (TrACSS) is jointly administered by FAO, WOAH, WHO and UNEP.