The Abuja High-Level Ministerial meeting: a chance to renew ambition and improve accountability to make the global response to antibiotic resistance more effective

2026-04-17

The upcoming 5th High Level Ministerial Meeting on AMR held in Abuja, Nigeria in June 2026 should serve as a political turning point for renewed ambition, reinforced accountability, and accelerated implementation. Here ReAct outlines recommendations for ministerial action centered around four key themes: financing, governance & accountability, community and civil society engagement, and finally equitable access to AMR countermeasures.

Antibiotic resistance is a global crisis that is undermining treatment of infections, threatening food systems, straining fragile health systems, and deepening inequities within and between countries. Despite the increased awareness of the scale of the threat, progress remains slow. The 2024 UN General Assembly High-Level Meeting (UNGA HLM) on Antimicrobial Resistance (AMR) marked an important milestone by setting clear, measurable global targets which now need to transition into a delivery phase.

Prevention is foundational: basic water, sanitation, hygiene (WASH), and infection control in healthcare facilities can no longer be treated as optional. Urgent action is needed to advance towards the target of 100 per cent of healthcare facilities having basic WASH services, and toward 90 per cent of countries meeting WHO minimum requirements for national infection prevention and control programmes. The same is true for strengthening antimicrobial stewardship, scaling access to quality diagnostics, and expanding surveillance. Ensuring that countries participate in TrACSS, while improving the quality, transparency, and use of the data, should be a minimum expectation for global accountability.

To strengthening the commitments on antibiotic use in animals in the 2024 political Declaration, the Abuja meeting should galvanise action across agri-food systems to initiate meaningful reductions on antimicrobial use and scaling animal vaccinations. This is central to a more robust One Health response, supported by domestic investment and coordinated national and regional action.

Step up financing for AMR National Action Plans implementation

Despite the growing global threat of antibiotic resistance, financial commitments remain far below what the challenge demands. While the 2024 UNGA HLM political declaration marked important progress by introducing concrete resource mobilization targets, a persistent disconnect between recognition and resources risks leaving many AMR National Action Plans largely symbolic. Several barriers hinder progress: AMR is often perceived as a technical, distant issue rather than an urgent political priority; fragmented global financing creates complex, poorly aligned funding at country level; Official Development Assistance (ODA) is being significantly reduced across several donor countries and; a turbulent economic environment in combination with rising debt burden is leaving countries, especially in Africa, to spend more on debt servicing than on health care. To ensure real implementation, global leaders must stabilize and improve international financing while strengthening domestic ownership of AMR responses.

Strengthen governance and accountability

Global governance on antimicrobial resistance has advanced significantly since the 2016 UN High-Level Meeting on AMR, with a more structured architecture emerging through the Quadripartite Joint Secretariat and platforms such as the Global Leaders Group and the AMR Multi-Stakeholder Partnership Platform, alongside the forthcoming Independent Panel on Evidence for Action on Antimicrobial Resistance. Yet important gaps remain.

Current governance still relies heavily on inconsistent self-reporting. Clearer mandates, stronger coordination, and more robust accountability are needed. Building on commitments from the 2024 UN HLM on AMR and the subsequent ministerial meeting in Jeddah, existing mechanisms – particularly biennial ministerial conferences – should be strengthened and formalized to enhance accountability and facilitate multi-sectoral learning.

Looking ahead to the 2026 Abuja meeting, world leaders have a critical opportunity to move beyond “business as usual” and advance a governance system capable of translating political commitments into real-world implementation. Progress made in Abuja will also set the conditions for the longer-term trajectory of establishing agile and robust governance systems and mobilization must start now.

Enabling community and civil society engagement

The Global Action Plan on AMR and the WHO’s people-centred approach both highlight the importance of engaging communities in designing and implementing solutions. This was reaffirmed by the 2024 UNGA political declaration which explicitly called for a “whole of society approach” and the engagement of local communities, CSOs, FBOs, and youth in the design, implementation, and review of national action plan, while noting the disproportionate burden on vulnerable populations. The Jeddah commitments equally reinforced this direction by emphasising transparent, inclusive, and accountable governance, stronger education and awareness, and a whole-of-society, people-centred approach. However, despite platforms like the AMR Multi-Stakeholder Partnership Platform, and the newly launched WHO Civil Society Taskforce, progress towards meaningful inclusion of community, youth, and civil society voices remains limited.

The global expansion of platforms has not been matched by dedicated funding, leaving participation largely consultative rather than decision-shaping. Vulnerable groups are often acknowledged but not prioritized through financed and targeted interventions. This gap persists against a challenging backdrop of a shrinking civic space, political polarization, trade policies, market lobbies, and regulatory capture.

Advance public health driven innovation and access policies and action

Equitable access to well-stewarded antibiotics and other health technologies relevant for mitigating antibiotic resistance is critical. Yet, major gaps in health systems, exposed during the COVID-19 pandemic and worsened by recent funding cuts, continue to limit access in many LMICs. At the same time, global research and innovation incentives remain skewed toward high-income country markets, often overlooking the needs of the most affected populations.

Recent global and regional commitments signal an opportunity to shift course. The 2024 UNGA HLM on AMR and ongoing pandemic preparedness efforts emphasize equitable access, system strengthening, and technology transfer. Innovation of new antibiotics is increasingly taking place in Asia and in Africa, regional initiatives on regulatory harmonization, manufacturing and sustainable innovative financing provide important policy solutions for more resilient and self-reliant supply systems. These developments and frameworks promote pivotal aspects such as technology transfer that enables regional production and opportunities to advance sustainable pooled procurement mechanisms. A novel pathway and a broader set of actors to that may better align innovation with public health needs and priorities, and strengthen equitable access to antibiotics and other relevant health technologies is starting to emerge and should be further encouraged. In light of the above, we call for renewed, galvanized action by countries to advance public health driven R&D and access through an equity lens.

Amid geopolitical turmoil and shrinking development assistance, the threat of antibiotic resistance is escalating. It is essential that the 5th Ministerial High-Level Meeting on AMR moves beyond rhetoric to deliver practical, actionable outcomes. Coordinated global action is now vital to bridge the gap between commitment and implementation, ensuring equitable access and safeguarding antimicrobial effectiveness for future generations.