0
0
By Shobha Shukla, Bobby Ramakant
The 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-quality 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 has been addressed in the past few years. We are referring to antimicrobial resistance (AMR) or drug resistance, which is fuelled by the misuse and overuse of medicines. Because of AMR, disease-causing bacteria, viruses, fungi, and/or parasites 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 in 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 the 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 countries have come up with their national AMR action plans globally. But only 1 in 10 countries is 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 the 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 implement them by 2030.” Currently, only 11% of 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?
The 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 the One Health approach, was the 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 is 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 the 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 the 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 the typhoid conjugate vaccine (TCV) to prevent typhoid fever caused by the bacteria Salmonella typhi. Typhoid fever was also a cause of increasing AMR. Using AMR MPTF resources, we are tracking the impact of introducing TCV. We saw a reduction in the incidence of typhoid fever from 1373 per 100,000 before the introduction of the TCV vaccine to 341 per 100,000 after the introduction of the TCV vaccine. This has also resulted in a reduction of AMR,” said Dr Mashe.
“By introducing the 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 the more expensive azithromycin. So, the typhoid conjugate vaccine has not only reduced AMR but also reduced the expenditure for the 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. The 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 transitioned from the AMR inter-ministerial committee towards a broader One Health governance framework.
“Without enough financial resources, before MPTF funding, Cambodia’s efforts to implement the 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 have happened 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 the 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 the 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 the 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 the AMR multi-sectoral action plan 2025-2030. We are going to develop an additional legally binding policy document to strengthen and reinforce antimicrobial use in the animal health sector,” added Dr Mak.
MPTF protects livelihoods and safeguards the 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 trusted mechanism that is efficient and effective. It ensures that the investments align with the country’s needs and the country’s own priorities,” added Dr Eklund.
