Reductions in global health funding heighten the need for improved prioritisation of the remaining funds. Antimicrobial resistance (AMR) is an agreed priority, predicted to account for 1·91 million attributable deaths annually in humans by 2050. Ambitious AMR reduction targets were set by member states at the 2024 UN General Assembly. Global and national processes must now carefully consider how evidence can be best applied to prioritise actions to achieve these goals. The Global Action Plan is being revised by the quadripartite of WHO, the Food and Agriculture Organization, the World Organisation for Animal Health, and the UN Environment Programme. AMR national action plans are undergoing revision, as their first iterations had struggled to move from paper to practice. An immediate challenge for all involved is prioritisation of the expanding array of proposed interventions, with an increasingly wide range of actors and effects. Insufficient attention has been paid to the relative contributions of different interventions to mitigating the AMR burden, their cost, and the feasibility of implementation. This issue must be a focus for the Independent Panel on Evidence for Action on AMR agreed in the UN General Assembly declaration, to ensure a robust process to compare and rank interventions in different contexts.
Many interventions across One Health settings seek both to predict and reduce the AMR burden, yet evidence on the cost-effectiveness and technical, behavioural, and political feasibility of implementation is unsystematic. The burden of drug resistance is not only manifested in human mortality, but also in economic and social outcomes. This situation is reminiscent of many environmental challenges, particularly global climate change governance and greenhouse gas mitigation efforts about 40 years ago. Although not identical, the AMR-climate parallel offers lessons on how to consider technical evidence at different scales to guide public policy and foster private-sector engagement.
The United Kingdom Research and Innovation AMR Flagship funded eight transdisciplinary networks in 2024, including IMPACT AMR—a network bringing together stakeholders with expertise and interest in reducing the AMR burden across different settings, collectively working to answer the question, where should limited resources be allocated to have the greatest effect on the burden of AMR? This work builds on early efforts to construct an evidence base on the return to investment in different AMR interventions, including economy-wide models developed by the Organisation for Economic Co-operation and Development on the economics of AMR.
Through a series of stakeholder engagements from 2024–28, the network will refine frameworks to prioritise AMR interventions in different settings and across sectors. The invitation to participate is open. This is a key time for action on AMR, requiring a robust and transparent pathway from evidence to prioritised action.
By: The Lancet