New ReAct Policy Brief: Unlocking AMR Financing: Optimizing international resources for an accelerated response to antibiotic resistance

2025-10-30

Antibiotic resistance is one of the greatest global health problems, with far-reaching consequences if urgent action is not taken to prevent a post-antibiotic era. Within the broader concept of antimicrobial resistance (AMR), resistance to antibiotics is the greatest and most urgent global risk. Yet, funding and coordination for action remain far behind the scale of the challenge. A new ReAct analysis and policy brief highlights persistent barriers that hinder countries from optimally accessing and using international financing to implement their National Action Plans on Antimicrobial Resistance (AMR NAPs). It also identifies opportunities to make global AMR financing more coherent, efficient, and accessible, and outlines pathways to strengthen global mechanisms for more coordinated and effective AMR funding.

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A disconnect between recognition and resources

While governments and global institutions increasingly acknowledge antibiotic resistance as a critical development and health priority, resources dedicated to addressing it remain critically insufficient.

Effective implementation relies on National Action Plans (NAPs) at the country level.

However, countries continue to face difficulties in accessing the limited funds that are available, and existing international mechanisms are often perceived as fragmented, siloed, and narrowly focused. This disconnect is occurring against the backdrop of a turbulent global financing landscape marked by declining official development assistance (ODA) and increasing strain on health systems, particularly in low- and middle-income countries.

Understanding the barriers

ReAct’s analysis draws on interviews and surveys with around 20 stakeholders, including national advisors from Africa, Latin America, and Asia-Pacific, as well as representatives from key multilateral financing institutions and technical agencies. The work also builds on previous ReAct dialogues on increased action and financing to mitigate the challenge of antibiotic resistance, aiming to deepen understanding of the main barriers faced by both funders and recipients.

The study focuses on four major multilateral mechanisms that over the past few years have increasingly provided funding for AMR NAPs:

• The World Bank (WB),
• The Pandemic Fund (PF),
• The Global Fund to Fight AIDS, Tuberculosis and Malaria (GF) and
• The AMR Multi-Partner Trust Fund (MPTF).

While these mechanisms have evolved, establishing guidelines and allocating funds for AMR interventions, uptake remains relatively limited compared to the need. The 2024 UNGA High-Level Meeting (HLM) on AMR acknowledged the financing gap and set a target of mobilizing USD 100 million in catalytic financing through the MPTF.

Although this scope of the analysis is intentionally narrow, it sheds light on broader systemic challenges affecting how AMR is financed internationally, and provides a foundation for wider dialogue on potential solutions.

Key findings and challenges

The analysis identified a range of key challenges and barriers associated with international financing for AMR implementation, originating either at the national level within recipient countries, at the level of the specific financing mechanisms, and across the broader global policy and financing ecosystem.

Across these levels, a few overarching categories of key challenges are highlighted here:

• Limited political prioritization of AMR: AMR often remains low on domestic political and budgetary agendas. This hampers integration into national health and development plans and countries’ ability to mobilize or sustain funding for NAP implementation.
• Data evidence, capacity and narrative gaps: Deficiencies in quality data and technical capacity limit the ability of countries to prepare high-quality proposals and translate the impact of AMR into visible economic costs. This constraint is amplified by framing difficulties that fail to make the link between AMR and broader development issues visible enough to attract sustainable resources.
• Structural constraints and uncoordinated international financing landscape: Several constraints in criteria, limitations in scope and technical requirements exist within existing mechanisms which restricts AMR-related activities, and limits efficient access to financing. The current global funding for AMR dispersed across multiple mechanisms is fragmented with limited alignment between donor priorities and national needs. This lack of coordination results in inefficiencies, overlaps, and missed opportunities for synergy.

These challenges are compounded by reductions in global health financing and competing demands on existing funds. Declines in ODA and shifting donor priorities have intensified competition for limited resources, placing additional strain on health systems in  in low- and middle-income countries that depend on external support. Many countries rely heavily on international funding to sustain AMR activities, leaving them vulnerable to external fluctuations. Limited fiscal space, weak institutional capacity, and the absence of dedicated AMR budget lines further constrain long-term sustainability.

Optimizing coordination on AMR financing

Recognizing the systemic nature of many of the funding constraints, there is a need for structural solutions at the inter-agency and global level to enhance coordination, coherence, and dialogue. While the prospects for launching a completely new financing mechanism dedicated solely to AMR appear limited at this time due to the current geopolitical and financial context, efforts must focus on reviewing and expanding the role of the existing AMR MPTF. The MPTF should be supported to meet or exceed the UN HLM catalytic funding target.

In addition, alternative and complementary coordination functions must be explored, such as establishing an AMR financing coordination mechanism or collaboration hub to provide guidance and support to countries and funders, improving the coherence, efficiency, and harmonization of existing mechanisms.

Furthermore, formalizing dialogue through country-donor dialogue platforms, as proposed through the Multi-Stakeholder Partnership Platform (MSPP), is necessary to strategically align fragmented international support and ensure funded activities reflect urgent national needs.

Recommendations for a more effective response

A call for renewed ambition

Antibiotic resistance continues to threaten decades of progress in global health, development, and equity. Addressing this challenge requires both increased resources and effective coordination – ensuring that available funds reach the countries and sectors where they are needed most.

Release of this brief is part of ReAct 20 years:
AMR financing is central in ReAct’s work

The story of ReAct began 20 years ago with a small group of passionate global health advocates, several of whom are still part of the network today. Driven by the urgency of antibiotic resistance, ReAct has grown into a global movement with offices across four continents, influencing policy, empowering communities, and shaping governance.

Despite progress, global efforts remain insufficient, and urgent action is needed. ReAct remains committed to driving stronger responses to safeguard effective antibiotics for all.

ReAct’s 20-year journey has transformed AMR governance, strengthened health systems, and mobilized communities worldwide. As we look to the future, we invite partners and funders to join us in scaling impact, driving innovation, and securing sustainable solutions — for a world free from untreatable infections.

The story of ReAct.