ReAct’s 2025 Impact Report: From grassroots action to global policy

2026-05-27

We are proud to share ReAct 2025 Impact Report, highlighting key achievements from across the ReAct network over the past year. 

In 2025, we also marked an important milestone: 20 years as a global network working to ensure equitable access to effective antibiotics for all. This work has always been collective, and we could not have done it alone. Our sincere thanks go to communities, civil society organizations, individuals, institutions, and donors who contributed to and been engaged in our work in 2025 - and throughout the past two decades.

In a bustling neighbourhood clinic in Delhi, women-led health groups are reframing antibiotic resistance not as a distant medical concept, but as a tangible discussion on health rights, hygiene and recurrent infections.

Thousands of miles away in Zambia, Christian and Muslim faith leaders use newly developed sermon guides to present infection prevention and responsible antibiotic use to their congregations as a collective moral duty and a matter of intergenerational justice.

Meanwhile, in Ukraine, ReAct delivered a specialized three-part online lecture series for health care personnel focused on antibiotic resistance and infection prevention and control in conflict-affected settings.

Together, these community-rooted novel interventions organised by ReAct illustrate how the global response to antibiotic resistance has fundamentally evolved over the last two decades. What was once treated as a narrow, technical issue confined to specialist medical circles is now increasingly recognized as a crisis affecting human and animal health, as well as the environment – a One Health challenge deeply intertwined with equity, governance, and sustainable development.

Contracting global health financing landscape

However, as ReAct’s new 2025 Impact Report points out, this understanding of antibiotic resistance is manifesting itself during a highly volatile period. 2025 was marked by a contracting global health financing landscape, characterized by cuts to bilateral aid programmes and shifting development priorities following the 2024 UN General Assembly High-Level Meeting on Antimicrobial Resistance (AMR). Total development assistance for health was estimated to have dropped by roughly 20%, causing many low- and middle-income countries to turn toward more self-reliant, country-driven funding pathways.

In this new context, ReAct has strategically focused its efforts. Among other measures, it has supported efforts of national and global institutions to move from commitments to implementation, including by allocating resources for AMR-related interventions and policies.

Securing political ownership within legislative systems

A central focus of ReAct’s governance work in 2025 was moving beyond temporary political declarations toward more lasting institutionalization of the issue at national level. Through the efforts of ReAct Africa, the Zambian Parliament established an official, newly minted Parliamentary Caucus on AMR supported by a dedicated secretariat.

By identifying concrete legislative entry points – such as committee workflows and routine ministerial oversight – antibiotic resistance, and AMR more broadly, has been integrated directly into Zambia’s legislative system. Engaging parliamentary clerks further ensured that the problem remains a political priority beyond electoral cycles.

“Building institutional durability is a key priority. By establishing the first-ever AMR Parliamentary Caucus in Zambia and training nearly 800 students through our leadership programmes this year, we ensure that governance structures in Zambia can remain over political cycles, while also empowering the next generation of leaders,”

says Prof. Mirfin Mpundu, Director, ReAct Africa.

ReAct also actively explored similar parliamentary engagement models in both India and Indonesia. This work involved working with introducing antibiotic resistance into existing legislative structures to support long-term political ownership and policy continuity on the issue.

Moving from national strategy to front line practice

Translating high-level national strategies into properly financed action tailored to local contexts remained a key priority in 2025. In India, ReAct provided technical assistance to adapt the evolving National Action Plan (NAP 2.0) to state-level realities across Telangana and Andhra Pradesh. Through multi-stakeholder dialogues, ReAct assisted these states in adapting national priorities into localized planning.

Concurrently, ReAct demonstrated how clinical stewardship can be used in daily healthcare workflows. At the Ananthapuri Hospital and Research Institute in Trivandrum, India, ReAct supported the introduction of “Dr. Antibot”, an AI-driven WhatsApp chatbot designed to provide real-time, evidence-based guidance to both healthcare providers and patients.

ReAct Asia-Pacific’s Antibiotic Smart Communities initiative has also helped improve antibiotic resistance literacy in primary healthcare delivery settings in Delhi. By partnering with a women-led primary health care organization working with people living with HIV, antibiotic resistance was framed through the lens of co-infections, Water Sanitation and Hygiene (WASH), and health rights.

“In the Asia Pacific region, one of our key priorities is to transform antimicrobial resistance from a global health challenge into a community conversations and solutions. Through initiatives like the Antibiotic Smart Community, we are strengthening community stewardship and inspiring collective action for responsible antibiotic use.”

says Dr. S.S. Lal, Director, ReAct Asia Pacific.

Safeguarding stewardship and front lines in conflict zones

In 2025, ReAct also embarked on work to mitigate antibiotic resistance under acute crisis conditions, including in armed conflict settings. In Ukraine, where health systems are severely overstretched by the ongoing war, ReAct supported mitigation efforts through trainings to strengthen the capacity of the country’s heavily burdened nursing workforce. Partnering with Ukrainian and Swedish institutions, including the Ukrainian aid organization Zdorovi, these online trainings engaged approximately 2,000 healthcare professionals across the country.

Community and youth mobilization as governance enablers

In 2025, ReAct Latin America´s Empowered Communities initiative expanded its regional footprint across Latin America, engaging community groups across more than a dozen countries. These efforts helped connect civil society advocacy with formal state policy processes.

For example, grassroots community networks in Bolivia organized an academic seminar at the Universidad Mayor de San Andrés, and subsequently submitted a formal draft bill on Food Safety and AMR to the Bolivian Ministry of Health.

In Ecuador, dozens of academics, ecologists, farmers, and health activists also gathered as part of the ‘Assembly of the Soil’ to understand antibiotic resistance as an ecosystem and food-system issue, emphasizing the multi-dimensional nature of the crisis.

“Through initiatives like the Assembly of the Soil, we are showing that antibiotic resistance is not just a medical issue, but an ecosystem challenge – addressing it starts with the health of our food production systems and the vitality of our communities,”

says Arturo Quizhpe Peralta, Director, ReAct Latin America.

This bottom-up approach was mirrored in youth leadership work, which is moving beyond awareness raising towards empowering youths to become governance and policy engagement actors. In Africa, the AMR Leadership Programme trained nearly 800 tertiary-level students across multiple countries, establishing university-based ‘One Health Clubs’ and positioning young people as active contributors to national policy dialogues.

In Asia Pacific, the Regional Youth Task Force on AMR connected youth leaders from 15 separate organizations, enabling them to actively contribute to global policy spaces, such as the Quadripartite Working Group, where they advocated on the intersection of antimicrobial pollution, climate change, and global health governance.

Reshaping the global R&D and financing architecture

Beyond local healthcare and community organizing, ReAct continued to engage in structural policy change in global research and innovation of new antibiotics. In Europe, ReAct engaged on the revision of the EU pharmaceutical legislation and advocated for the implementation of a “delinked” model of financing research and development, introduction of access and stewardship plans as well as more targeted incentives for the early stages of antibiotic research.

ReAct looks ahead to Abuja 2026

As global preparations advance toward the 2026 High-Level Ministerial Meeting on AMR in Abuja, Nigeria, the work done throughout 2025 provides a stronger foundation to advance the response on going forward. ReAct’s achievements in its 20th anniversary year demonstrate that political declarations alone are not enough to safeguard the effect of antibiotics effective.

“We are mobilizing as a global network, leveraging voices from youth, communities and civil society to get as much impact and action as possible, so that the ministerial meeting in Nigeria can deliver on increased funding for the work in low- and middle-income countries to advance on commitments to ensure equitable ans sustainable access to effective antibiotics,”

concludes Anna Sjöblom, Director, ReAct Europe.