SHOBHA SHUKLA, BOBBY RAMAKANT – CNS
Right to health is a fundamental human right. There is no doubt that everyone – without any exception or exclusion – should be able to live healthily in a rights-based manner – everywhere. Along with ensuring high to health is a reality for all, it is also important to recognise health financing as a smart investment.
One important example is how one of the top threats to global health and food safety and security have been addressed in the past few years. We are referring to antimicrobial resistance (AMR) or drug resistance, which is fuelled by misuse and overuse of medicines. Because of AMR, disease-causing bacteria, virus, fungi and/or parasite become resistant to the medicine (due to inappropriate use of medicine) – and therefore, these medicines become ineffective.
Misuse and overuse of antimicrobial medicines is rampant in human health, animal health and livestock, food and agriculture – and also polluting our environment.
So, to address AMR, we need a multi-sectoral response that prevents it in all the sectors where inappropriate use of medicines is happening.
That is why, global agencies on these sectors, the World Health Organization (WHO), Food and Agriculture Organization of the United Nations (FAO), United Nations Environment Programme (UNEP) and World Organisation for Animal Health (WOAH) joined hands – now known as Quadripartite Joint Secretariat on AMR.
“Addressing AMR requires urgent, coordinated action and sustained commitment from governments and diverse sectors across the One Health spectrum,” said Dr Jean-Pierre Nyemazi, Director of the Quadripartite Joint Secretariat on AMR.
9 in 10 countries with national AMR action plans have NO financing to implement them
Over 90% of the countries came up with their national AMR action plans globally. But only 1 in 10 countries are fully implementing these plans with monitoring and financing in place. For 9 in 10 countries with national AMR action plans, financial crunch has paralysed them from addressing one of the top global health threats using One Health approach.
World leaders at the 2024 UN General Assembly High Level Meeting on AMR had adopted a Political Declaration – one of the promises of which is to ensure that at least 60% of the countries must have fully funded national AMR action plans and implementing them by 2030.” Currently, only 11% of the countries have national AMR action plans with financing in place.
But, where domestic health financing is not adequate, who will fund a multi-sectoral and inter-ministerial national AMR action plan?
AMR Multi-Partner Trust Fund came to life in 2019
One option that came to life since 2019 to help low- and middle-income countries to seek financing to implement their national AMR action plans, based on One Health approach, was AMR Multi-Partner Trust Fund of the UN. It was established with an initial US$ 5 million funding from the Netherlands in 2019 so that governments could implement their national AMR action plans where needed in low- and middle-income countries.
Dr Nyemazi who leads the Quadripartite AMR agencies said in the 5th Annual Global Media Forum on Antimicrobial Resistance: “For us to reach that goal (at least 60% of countries to have fully funded national AMR action plans and implementing them by 2030), governments also committed to mobilise at least US$ 100 million by 2030, including through AMR Multi-Partner Trust Fund (AMR MPTF) and other mechanisms. This is a powerful signal that the world understands the urgency and shared responsibility. However, technical solutions alone won’t win this fight. We need a shared responsibility.”
AMR MPTF is the world’s principal pooled-financing mechanism specifically to support low- and middle-income countries implement and strengthen multisectoral AMR National Action Plans.
World AMR Awareness Week (WAAW 2025) observed globally every year during 18-24 November is another reminder for richer governments to fully replenish the fund for global health security.
We cannot afford to lose the gains made in addressing compelling health challenges
“The gains made in AMR policy development, risk stalling without the means to act,” said Dr Emmanuel Kabali, AMR Project Coordinator, Food and Agriculture Organization of the UN (FAO).
The AMR MPTF uniquely harnesses the expertise of the AMR Quadripartite agencies to advance country-led actions across human, animal, plant, and environmental sectors. It is breaking silos because it blends high-level global governance, surveillance, and policy with collaborative local action by leveraging knowledge and coordinating efforts of resource partners, governments, community-based organisations, and other sectors. AMR MPTF is bridging and filling gaps.
AMR MPTF saving lives and reducing economic loss in Zimbabwe
Thanks to AMR MPTF, Zimbabwe revived domestic production of the BOLVAC vaccine to combat tick-borne disease (in cattle etc), reducing antibiotic misuse and linking the AMR response to high-priority livestock sector issues, ensuring sustainability, shared Dr Tapfumanei Mashe, AMR Project Coordinator, WHO Zimbabwe. “Zimbabwe is an agricultural economy. So, with initiatives like BOLVAC vaccine we are not merely addressing antimicrobial resistance but also addressing the economic loss it was causing.”
“There are a lot of scientific studies to show impact of expanded vaccination programmes and improved water, sanitation and hygiene in addressing AMR effectively – we can avert 750,000 deaths occurring due to AMR every year in low- and middle-income countries (LMICs) with such proven approaches,” said Dr Mashe.
“In 2019, Zimbabwe also introduced typhoid conjugate vaccine (TCV) to prevent typhoid fever caused by bacteria Salmonella typhi. Typhoid fever was also a cause of increasing AMR. Using AMR MPTF resources we are tracking impact of introducing TCV. We saw a reduction in incidence of typhoid fever from 1373 per 100,000 before introduction of TCV vaccine to 341 per 100,000 after the introduction of TCV vaccine. This has also resulted in reduction of AMR,” said Dr Mashe.
“By introducing typhoid conjugate vaccine, we are not merely addressing AMR but also addressing healthcare of the people and reducing costs which the government was incurring for those with typhoid. In 2018, the first-line medicine for typhoid (ciprofloxacin) was not working because of drug resistance, so we had to treat with azithromycin which was more expensive. So, typhoid conjugate vaccine has not only reduced AMR but also reduced the expenditure for government as well as mortality and morbidity for the people,” said Dr Mashe.
“As a result of multi-sectoral team working together, we have strengthened surveillance, where we are tracking antimicrobial resistance in different sectors, including human health, animal health, environment and food and agriculture. Quality of medicine is another important area to focus on for us in Zimbabwe. Thanks to AMR MPTF, Zimbabwe is also tracking phosphide resistance by setting up a surveillance system where we can check the prevalence of fortified medicines circulating in the country,” added Dr Mashe.
Cambodia had ambition but no means: MPTF enabled it to go the One Health way
In 2019, Cambodia had a multi-sectoral national AMR action plan but hardly any finances to implement it. AMR MPTF funding not only enabled it to implement the plan but also transition from AMR inter-ministerial committee towards a broader One Health governance framework.
“Without enough financial resources, before MPTF funding, Cambodia’s efforts to implement AMR National Action Plan were very fragmented. When MPTF funding came to Cambodia, we were able to significantly step up the implementation of Cambodia’s National Action Plan on AMR. Resourced by MPTF, we established Cambodia’s national multi-sectoral coordination body based on the One Health approach. It brought together different agencies in sectors like human health, animal health and livestock, food and agriculture, and environment,” said Dr Makara Hak, Adviser on Animal Health, FAO (Food and Agriculture Organization of the United Nations), Cambodia. “Thanks to MPTF support, different committee meetings were convened regularly to review policy regulations to guide implementation of Cambodia’s AMR National Action Plan – something which could never happen in the past.”
“Cambodia could also accelerate its capacity building efforts at national as well as sub-national levels to address AMR. Over 200 provincial and district veterinarians and over 1000 village animal health workers in the private sector have been trained as per the AMR treatment guidelines. All this could happen due to the support of MPTF,” confirmed Dr Mak.
“Thanks to MPTF, Cambodia could invest in strengthening animal health laboratories which is very important for addressing AMR as well as for AMR surveillance systems. Cambodia introduced Laboratory Information Management System to ensure that data meets international standards. We also invested in building the capacity of the academia and laboratories (including fishery laboratories) as part of Animal Health Laboratory Network,” said Dr Mak.
“This progress in Cambodia has unlocked new opportunities to further strengthen AMR response. We received US$ 1 million from AMR MPTF to strengthen Cambodia’s capacity which enabled us to secure another US$ 34 million for AMR and One Health in Cambodia through German Development Bank (KfW). Now, we can not only sustain these efforts but also further build upon them,” he said.
Cambodia recently endorsed the 2nd phase of AMR multi-sectoral action plan 2025-2030. We are going to develop additional legally binding policy document to strengthen and reinforce antimicrobial use in animal health sector,” added Dr Mak.
MPTF protecting livelihoods and safeguarding medicines we depend upon
“Through the AMR multi-partner trust fund, low- and middle-income countries are building surveillance systems, strengthening laboratory capacity, improving infection prevention and control, and promoting responsible use of antimicrobials in human, animal and plant health. These initiatives are not abstract. They save lives. They protect livelihoods and they safeguard medicines we depend upon,” said Professor Ernst Kuipers, Global Leaders Group on AMR (GLG) member, and Former Minister of Health, Welfare and Sport, Netherlands.
“If we act decisively now, we can preserve the effectiveness of lifesaving medicines for generations to come. If we however delay, we risk losing the very tools that make modern healthcare possible,” concluded Prof Kuipers.
Investing in AMR MPTF is smart
“The European Commission supports and invests in the AMR MPTF because it ensures donor coordination. It avoids duplication and fragmentation, and it gives the beneficiary countries the flexibility to focus on their priorities and their needs. And it also strengthens the One Health response by aligning all the relevant sectors,” said Dr Gunilla Eklund, the European Commission’s Directorate-General for Health & Food Safety (DG SANTE), European Commission.
“MPTF is more than just a fund – it is a platform for partnership. And as such, we believe it is a smarter model for aid. It allows collective action to deliver more than what isolated projects would have done by themselves. And in these times, I think we cannot emphasize enough the importance of pooling resources in the current climate of tight budgets. The MPTF is a tried and a trusted mechanism that is efficient and effective. It ensures that the investments align, with the country needs and the country’s own priorities,” added Dr Eklund.
Shobha Shukla, Bobby Ramakant – CNS (Citizen News Service)
(Shobha Shukla is the Founder Managing Editor and Executive Director of CNS (Citizen News Service) and Chairperson of Global AMR Media Alliance since 2023. Bobby Ramakant is Health Science Editor of CNS and part of GAMA board. Follow them on X: @shobha1shukla, @bobbyramakant)
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