1 year after the UNGA High-Level meeting on AMR – Where are we now?

2025-09-26

One year after the second-ever High-Level meeting on AMR held on the sides of the United Nations General Assembly, we take stock of the global response and consider the consequences of the major changes in the global backdrop for the field.

2024 was an exceptional year for the work against antibiotic resistance. The UN high-level meeting in September and the subsequent ministerial meeting in Jeddah, Saudi Arabia in November brought unprecedented focus and attention to antibiotic resistance from governments, civil society, private sector and foundations as well as philanthropists.

A new and improved political declaration was adopted with a number of commitments, including the setting of an overarching goal to reduce death from antibiotic resistance by 10% in 2030, as well as a commitment to establish the independent scientific panel and a rotating Troika-system of high-level ministerial meetings in 2026; 2028 to be followed by another UNGA HLM in 2029.

Promising momentum

At the ministerial meeting in Jeddah, Nigeria committed to take over the baton from Saudi Arabia and host the 2026 ministerial meeting. As such we left 2025 thinking that a new level of structure and predictability had finally been established for the field, and that the trajectory for strengthening the global response to antibiotic resistance pointed upwards. The resounding motto across stakeholders was:

“Now is the time to keep the momentum going to ensure a more equitable response and more sustainable financing”.

Then came 2025 – and with it what has felt like an unrelenting flow of bad news.

The major game changer has of course been that the map of global development funding has been dramatically redrawn. The brutal and fast-paced shutdown of USAID compounded the reduction trend in development aid that had already been initiated by other major donor countries in Europe, who are redirecting funds into security and military expenditure as a result of the war in Ukraine.

Doing more with less

The effects of these deep cuts are still reverberating throughout the system and the full extent of the consequences is probably still to be seen. Global health institutions, and international organizations are currently trying their best to integrate agendas and find synergies to be able to do more with less, while others are choosing to go back to basics and core mandates to avoid spreading limited funds out too thin. Countries are equally scrambling to realign their funding against competing priorities with already limited budgets.

The consequences for the antibiotic resistance field are tangible. Departments, units and teams in international organizations and regional offices, like the WHO, are being decimated. The international pool of experts able to work on this global transboundary crisis is shrinking as a consequence. Financial resources to implement actions at all levels needed to reach the 2030 goal of reducing global deaths by 10% will most likely be reduced from already very low levels.

Against this background, Director of ReAct Africa, Prof. Mirfin Mpundu says:

“The heavy reliance on funding from the global North has led to non-alignment with local priorities, fragmented efforts, and lack of sustainable domestic financing mechanisms. We now need to work with governments to develop locally driven strategies and create more resilient financing mechanisms that can address national priority interventions to address antibiotic resistance in low- and middle-income countries”.

Broader engagement despite backdrop

An interesting emerging trend we, however, also observe is that over the last year broader engagement and interest in the issue seems to have happened. ReAct’s regional conferences held in the African region and more recently in the Asia Pacific region, both had record level participation both in terms of numbers of attendees and countries represented.

The recent consultations held by the Quadripartite on the establishment of the Independent scientific Panel, as well as the revision of the Global Action Plan drew in massive amounts of feedback.

Interest from academics and civil society actors from other fields – climate change, biodiversity, non-communicable diseases and environment seems to also be growing and showing interest in collaborations.

Not least work to engage communities in meaningful participation and actions in implementing national actions plans is gaining traction – in particular the field of education, engagement of youth and awareness raising.

Director of ReAct Latin America, Dr. Arturo Quizphe says:

“Taking a bottom-up One Health approach enables us to engage with actors involved in relevant broader agendas, such as climate change and sustainable food production. By involving communities and civil society across these linked agendas in developing the local, national, regional and global response, actions will be able to generate more sustainable and lasting change, even in the face of adversity we currently see in field of global health”.

Looking ahead to 2026

In hindsight, the commitment to establish the rotating troika of ministerial meetings has become even more important than it was perhaps perceived at the time. Without it, it would have been a distinct possibility that governments would not gather to discuss the global response to antibiotic resistance for another 5 years.

But luckily here we are – 2026 comes with the opportunity of the Ministerial meeting in Nigeria (and other regional meetings in the planning for next year) to reconvene political actors, civil society, communities and private sector.

ReAct will do its best to leverage the signs we see of broader engagement across regions, to find novel and innovative ways to progress towards the 2030 goal of reducing deaths by 10% from antibiotic resistance, and to continue to push for equitable access to effective antibiotics in our projects and in our policy and advocacy towards other actors.