As part of the AMR Multi-Stakeholder Partnership Platform monthly updates, we feature perspectives from experts on critical issues, progress, and key initiatives in our joint efforts against antimicrobial resistance (AMR).
This month, we spoke with Professor Dame Sally Davies, UK Special Envoy on Antimicrobial Resistance.
In a changing global landscape marked by emerging diseases, geopolitical tensions, climate change, and biodiversity loss, AMR remains deeply interconnected with other major health and development challenges. How can we ensure that AMR retains a prominent place in global political discussions while also advancing a practical and effective One Health approach to addressing it?
AMR is a systemic threat at the intersection of health security, food systems, economic resilience, and the environment. If we fail to act, an estimated 39 million deaths could be associated with AMR[1], alongside global economic losses of USD 1.5 trillion by 2050[2]. That alone should keep AMR firmly on the global political agenda. But this is not about pitching one global priority against another. We must move beyond treating AMR in isolation. Addressing AMR requires a One Health approach, and AMR is one of the clearest tests for how we design and implement solutions across sectors.
In an era of tightening fiscal space and rising global challenges, we should link AMR solutions to wider agendas including pandemic preparedness, sustainable agrifood systems, food security, health system strengthening and climate change.
Optimising antibiotic use, alongside investment in vaccination, WASH, infection prevention and innovation, delivers benefits across human, animal, plant, and environmental health while strengthening wider health and food systems.
One Health platforms, such as the MSPP, can help translate this into practice. By bringing together colleagues from the human, animal, plant and environmental health communities to deliver a shared vision and facilitate exchange of best practice, they can reduce duplication, close gaps, and support more coherent policy.
We need to maintain momentum. The updated Global Action Plan on AMR, with greater emphasis on the environment and strengthened governance, alongside the anticipated establishment of the Independent Panel for Evidence for Action on AMR (IPEA), provide a crucial opportunity to sustain political attention and provide the evidence needed to support Member States in the implementation of their commitments.
With the updated Global Action Plan on AMR now adopted by the governing bodies of WHO and WOAH, and progressing through FAO and UNEP processes, what immediate steps should we all take to translate this renewed global framework into concrete action and measurable results at national level? Looking back at the implementation of the previous Global Action Plan, what lessons should guide this next phase?
We have made progress since the first Global Action Plan in 2015. It catalysed widespread commitment, with 194 WHO members agreeing to develop National Action Plans, 178 of which are now in place. Yet too few of these are monitored, fully implemented or sufficiently funded.
The question is “Where do we go next?”. The lesson is clear: we do not have a lack of solutions, but a more serious delivery problem.
The updated Global Action Plan, aligned with commitments made at the 2024 UNGA High-Level Meeting, provides a stronger, more prevention-focused framework. Success now depends on countries turning this ambition into costed, prioritised and financed national plans, embedded across One Health systems and informed by high-quality local data. Stronger data, achievable goals, greater transparency and real accountability will be essential to track progress, identify remaining gaps and turn global commitments into impact on the ground.
The UNGA 2024 Political Declaration provides the overall direction and ambition. To achieve meaningful progress before the next UNGA HLM in 2029, we must also learn from our shared experiences and insights into what works. Global forums, such as the MSPP, provide a vital platform for exchange, for instance by working closely with members to establish a Community of Practice for NAP coordinators that would:
- Strengthen peer-to-peer exchange among national AMR leaders and focal points.
- Build applied leadership and policy capability, including through targeted virtual learning opportunities;
- Share concrete solutions and best practices, particularly on multi-sectoral coordination and sustainable financing.
This will start with a pragmatic, informal and efficient model responding directly to the needs of countries.
The UK has long been a prominent champion of AMR, both domestically and internationally. What lessons can other countries draw from the UK's governance model, particularly in terms of cross-government coordination, sustained political leadership, financing, and accountability for implementation?
AMR cannot be delivered by health ministries alone. It requires formal, sustained cross-government leadership from health and agriculture to environment, research and finance, alongside diplomacy. It is fundamentally a whole-of-government and whole-of-society challenge.
The 2024 – 2029 UK National Action Plan provides a framework to coordinate this effort, linking domestic delivery with international commitments, including those from the 2024 UNGA High-Level meeting on AMR.
Delivery ultimately depends on accountability: clear targets, transparent reporting, and strong surveillance systems to ensure plans translate into action. This needs to be underpinned by adequate financing.
One area that we believe other countries could learn from is the UK’s antimicrobial subscription model - a solution that aims to revive the global antibiotic innovation pipeline while supporting good stewardship. Establishing this model requires coordination between multiple agencies and departments.
Lastly, we must also take the public with us. AMR will not be solved without broader awareness and engagement. When people understand, they care. When they care, they act. Innovative tools like e-bug to support engagement and education at an early age and novel forms of public engagement such as our AMR musical Lifeline, make AMR both understandable and relatable to new audiences – not as an abstract technical challenge, but profoundly human issue that affects us all.
Antimicrobials are often treated as commercial products, yet they form part of the critical infrastructure underpinning modern medicine, food systems, and public health. How can we shift the perception of AMR from being seen primarily as a human health issue to being understood as a broader structural challenge with implications for agrifood systems, the environment, economies, and societies?
We urgently need novel antibiotics and other antimicrobials, yet the global pipeline remains fragile, as the WHO has warned.
Effective antibiotics underpin modern medicine, but they are equally essential in animal health and in securing our food systems. Without them, our health systems, food systems, and economies are exposed.
The costs are already significant. Without action, global health care costs could rise to USD 150 billion annually, alongside wider economic losses and productivity impacts. Recent modelling suggests that in high impact scenarios, an 11% decline in livestock production in low-income countries[3], could reduce global GDP by $40 billion a year by 2050.4 The spread of resistant pathogens from livestock to humans, could cost another $77–$384 billion a year in GDP. [4]Yet investment in prevention, better treatment and innovation can deliver substantial returns in lives saved and economic benefit.
Shifting perceptions starts with how we communicate. We need to tailor the case for action to different audiences. For finance ministries, that means demonstrating both the costs of inaction and the return on investment – with some analysis suggesting returns of between 24 to 28 dollars for every dollar invested2.
For the public, it means making AMR tangible: its impact on families and friends, healthcare systems, the environment, and livelihoods – while also highlighting the actions each of us can take, from responsible antibiotic use, to supporting healthcare professionals and vets.
We must broaden our evidence base. Integrating social science insights will help us understand how individual and collective behaviours drive AMR – and how we can design more effective solutions. Innovative approaches, such as deliberative polling, offer new opportunities to engage the public, and leverage their insights.
If we position AMR as a cross-cutting risk to us all, and engage and mobilize the whole of society, we can ensure an effective response reflecting the lived realities of the 21st Century.
Nearly two years after the adoption of the UN Political Declaration on AMR, how do you assess progress to date? What needs to happen now to accelerate implementation, strengthen follow-up and ensure that commitments are achieved before the next UN High-Level Meeting on AMR?
Political declarations reflect our shared intent, but they only matter if they truly drive delivery. The 2024 UN Political Declaration was ambitious and comprehensive, but implementation is becoming more challenging.
We are navigating strong headwinds: funding pressures and shrinking fiscal space in many countries, growing distrust in institutions, climate change, urbanisation and underinvestment and conflict.
Together, they are weakening the animal, human and environmental systems that prevent and mitigate AMR, from surveillance and biosecurity to vaccination and alternatives to antimicrobials.
AMR is not a challenge we can afford to deprioritise, nor should action on AMR be siloed. Many of the most effective AMR interventions, such as immunisation, WASH, IPC and biosecurity in animal health and agriculture, are also among the most cost-effective investments we can make, delivering benefits across health, food security and economic resilience. If we get AMR right, we demonstrate that we can tackle complex global challenges. This is an opportunity and the responsibility before us.
Now is the time to be bolder to drive implementation, bringing together governments, civil society, and the private sector behind sustained political leadership, and greater investment in resilient systems across One Health. Cooperation and alliances are more important than ever. We must take others with us. Each of us must do our bit to solve this puzzle.