AMR activities and resources

Here is presented a summarised version, you can read the full report from John Rex here.

ESCMID Global once again held an afternoon of sessions focused on the intersection of AMR-related science and policy. With an overall theme of “Smart policies for lean times,” the well-attended afternoon comprised a pair of workshops, a plenary session, and a networking reception 

The afternoon’s parallel workshops were evidence-focused:

• Evidence for policy: modelling and economics
• Innovation for action: diagnostics and cost-effectiveness across the product development and implementation pathway

After the workshops, the plenary (opened by Robert Skov and then chaired by Jon Friedland) featured:

• (opening comments) Hon. Minister Mekdes Daba, Global Leaders Group on AMR, and Tedros Adhanom Ghebreyesus, WHO Director-General
• (keynote) “AMR policy action under pressure: doing more with less”: Naomi Rupasinghe (World Bank, Washington, USA)
• “Efficient and effective IPC”: Benedetta Allegranzi (WHO Regional Office for The Eastern Mediterranean, Cairo, Egypt)
• “Prevention pays off: vaccination policies for AMR” by Padmini Srikantiah (Gates Foundation, Seattle, USA)
• “Global AWaRe targets and national cost savings“: Koen Pouwels (University of Oxford, Oxford, UK)
• “A gram of prevention or a kilo of cure?“: Javier Yugueros-Marcos (World Organisation for Animal Health, Paris, France)

Naomi Rupasinghe’s keynote focused on the ways that she has been working from the World Bank to create workable investment opportunities in AMR. Her talk showed the path forward in AMR with an example from the vaccine world where the IFFIm (International Finance Facility for Immunisation) leveraged long-term pledges from 11 sovereign governments to raise $6.2b from the capital markets and immunise 233m children.

WHO’s Benedetta Allegranzi summarised the progress made in developing and implementing best practices for IPC. In 2023, there was the release of the WHO’s Global Strategy on IPC and then in 2025 the release of a practical guide to development and implementation of national action plans for infection prevention and control.

Padmini Srikantiah, Deputy Director at the Gates Foundation, epxlored the impact of vaccines. She noted that existing vaccines alone would annually avert 106k deaths, 9.1m DALYs, US$861m in hospital costs, and US$5.9b in productivity losses. She also highlighted the durability of vaccines showing that only a few of the vaccines end with a documented resistance-related failure in humans and even then, it takes many years for resistance to develop to vaccines as compared to often relatively prompt resistance to the drugs.

Koen Pouwels, reviewed his research on the value of adjusting prescribing patterns so that usage in the Access category of the WHO AWaRe (Access-Watch-Reserve) antibiotic ranking hits the UNGA HLM-AMR target of ~70%. Based on modelling that grouped regions by socio-demographic factors and infection patterns, substantial savings were possible.

Javier Yugueros-Marcos (World Organisation for Animal Health) reminded us that AMR is already causing $17b in annual GDP losses in livestock production with the potential for the cost to rise to $159b annually by 2050 if no action is taken. Building on a classic concept with his title “A gram of prevention or a kilo of cure,” he showed the potential for modern interventions to have a huge impact.

Finally, WHO’s Jean Pierre Nyemazi closed the session by first reviewing the political work that brought us to the 2024 UNGA HLM on AMR followed by a discussion of what is coming for IPEA (the Independent Panel on Evidence for Action as well as updates to the Global Action Plan (GAP) on AMR.

Around the world, health authorities are struggling to keep pace with increasingly interconnected threats — from climate-driven shifts that expand the spread of disease carrying species, to rising cases of diseases spilling over from animals to humans, and worsening antimicrobial resistance (AMR). In many regions, the basic ability to test bacteria and other pathogens is scarce or non-existent with information across human, animal, and environmental health remaining siloed and slowing detection. The result is delayed diagnosis, inappropriate treatment, avoidable antibiotic use, compromised patient outcomes, and slower recognition of new pathogens and outbreaks.

As countries refine AMR strategies and prepare upcoming G7 and multilateral commitments, the need for practical, collaborative action is urgent. It is in this context that these partners have developed the GO-Dx Compact — a collective effort to close diagnostic gaps, align action across sectors, and support countries in building more resilient, intelligence-driven health systems.

GO-Dx Compact marks a critical, multi-stakeholder step across the One Health interface toward prioritising diagnostics access and innovation, bolstering surveillance, and driving antimicrobial stewardship through education and training. By aligning with national and international policy frameworks and advocating for increased public-private collaboration, the Compact aims to increase accurate treatment, reinforce infection-prevention strategies, fortify health systems, and address the rising threat of AMR and other existing and emerging threats.

GO-Dx Partners and Commitments

The Compact is being advanced by a diverse group of partners spanning civil society, private sector, professional and scientific societies, foundations, and global health initiatives committed to One Health and AMR action. Together, they represent tens of thousands of infectious disease and microbiology professionals and support diagnostic, prevention and treatment pathways that reach tens to hundreds of millions of patients each year across health systems in more than 130 countries (find the complete signatories list below).

By endorsing the Compact, the signatories collectively commit to advancing four pillars:

1. Improved Access to Appropriate, High-Quality Diagnostics for All:
Expand affordable access to priority diagnostics across levels of care and geographies; support data and knowledge sharing to inform public health action.

2. Strengthened Stewardship and Appropriate Use of Diagnostics and Antibiotics:
Link access to last-line antibiotics with increased diagnostic utilisation; integrate diagnostic algorithms and context-relevant AMS training to reinforce diagnostic led decision making.

3. Investment in R&D to Meet Public Health Needs:
Advance innovation for human, animal, and environmental diagnostics, including solutions contextualised for resource limited settings, through public-private partnerships and open collaboration across industry, academia, NGOs, and public partners.

4. Improved Valuation and Integration of Diagnostics:
Work with governments, payers, and global partners to ensure diagnostics are appropriately valued, reimbursed, and integrated into clinical and public-health pathways, as well as in animal-health settings, reflecting downstream benefits such as reduced antimicrobial consumption and cost savings.

GO-Dx Compact Next Steps

The Compact signatories commit to advancing this shared effort, recognising that specific contributions will vary according to individual missions, business models, and areas of work. Each organisation will take forward the elements most aligned with its strategic focus while upholding the shared intent of advancing access, stewardship, innovation, and appropriate valuation of diagnostics. Where appropriate, organisations will engage with national governments and multilateral processes, including the G7, to support progress and help ensure diagnostics and surveillance are more systematically reflected in policy commitments, funding mechanisms, and global health strategies.

Full Partner List:

African Society for Laboratory Medicine, American Society for Microbiology, AMR Action Fund, Bavarian Nordic, bioMérieux, British Society for Antimicrobial Chemotherapy, CARB-X, Ceva Animal Health, Copan Group , Danaher Corporation, DxAMR Collaborative, European Society of Clinical Microbiology and Infectious Diseases, Infectious Diseases Society of America, InnotiveDx, International Society of Antimicrobial Chemotherapy, LifeArc, Liofilchem, Nostics, Novo Nordisk Foundation, Roche Diagnostics, Sysmex, Waters Corporation

The report Analysis of antibacterial agents in clinical and preclinical development: overview and analysis 2025 describes that the antibacterial pipeline is shrinking, with only 90 drugs in development—50 traditional antibiotics and 40 non-traditional. Just 15 of these are innovative, and only 5 target critical drug-resistant bacteria. There are notable gaps in paediatric and oral formulations, with minimal progress since 2017. The WHO calls for urgent investment and policy action to combat rising antimicrobial resistance.

The Landscape analysis of commercially available and pipeline in vitro diagnostics for bacterial priority pathogens report reviews global diagnostics for bacterial priority pathogens, focusing on AMR, particularly in low- and middle-income countries. It notes a lack of rapid, accurate diagnostics at primary and district healthcare levels, especially for bloodstream infections and AST. The report urges innovation in affordable point-of-care tests, expansion of host biomarker use, and R&D for simplified, resource-appropriate diagnostic platforms.

The Global antibiotic resistance surveillance report 2025 reveals a sharp global increase in antibiotic resistance, with surveillance now covering over 70% of the world’s population but still lacking data from Africa, Central Asia, and Latin America. Resistance is most severe in Gram-negative bacteria, especially to key antibiotics like cephalosporins and carbapenems. Low- and middle-income countries face greater risks due to limited monitoring and diagnostics. The report calls for more investment in surveillance, diagnostics, stewardship, and equitable access to both data and antibiotics.

In summary, the 2025 WHO reports collectively underscore the urgent need for coordinated global action to address the escalating threat of antimicrobial resistance. Strengthening health systems, expanding funding, and prioritising tailored interventions are critical steps to safeguarding the efficacy of antibiotics for future generations. 

Authored by Valentijn Schweitzer and Holger Rohde

References

• Analysis of antibacterial agents in clinical and preclinical development: overview and analysis 2025
• Landscape analysis of commercially available and pipeline in vitro diagnostics for bacterial priority pathogens
• Global antibiotic resistance surveillance report 2025
• WHO releases new reports on new tests and treatments in development for bacterial infections

SCIENTIFIC INDEPENDENCE: The “I” in “IPEA” stands for “independent”. Yet, the Zero Draft is meant to establish a panel with strong “inter-governmental” features, similar to the IPCC and the IPBES. The UNGA was aware of these panels but chose to invite the establishment of a scientifically “independent” panel instead. The Zero Draft does not fully honour this choice: e.g., the six scientists leading the work (the “Interdisciplinary Expert Committee”) are nominated by the Quadripartite and elected by the Plenary, and the scientific work programme is first drafted by the Secretariat, then approved by the Plenary. Nothing about the structure envisioned in the Zero Draft supports the independence of IPEA’s scientific work. For example, the great bulk of the work of IPEA should be in response to deliverables requested by Member States, but the IPEA should have the ability to initiate reports as well. 

INCLUSION AND REPRESENTATION: There are only six core experts proposed in the Zero Draft. Sufficient diversity across disciplines (including social science and other areas under-exploited in AMR discourse and inquiry), sectors (all One Health domains), and geographies cannot be met with only six individuals. Attempts to do so will inevitably exclude groups historically under-represented in AMR policy decision-making such as youth and LMIC representatives. Though recognising that resources will be limited, we suggest expansion of this core, as well as a broad call for nominees. 

DUPLICATION AND WASTE: UNGA insisted IPEA should be “making use of existing resources and avoiding duplication of on-going efforts,” but the Zero Draft features four levels of governance, plus the actual working groups of scientists. No role is found for three other elements of global governance already in existence: (a) the GLG; (b) the biennial Ministerial Conference; and (c) the MSPP. What is the relationship between the Plenary and the Ministerial? E.g., should the Ministerial be given an additional key role, something along the lines of the COP? How will IPEA interact with the GLG and the MSPP? E.g., should the MSPP be used to channel multi-stakeholder input? 

CLOSE EVIDENCE GAPS: We welcome that gap identification is one of the functions laid out in the Zero Draft. As the Draft also emphasises that IPEA will not generate evidence, it is important to consider how the Panel can support and frame priorities for capacity strengthening for evidence-generation. Otherwise, lopsidedness in evidence availability, from resource rich settings versus resource poor ones, will continue. 

LAGOS LESSONS LEARNED MEETING. We further wish to highlight that signatories of this letter convened and attended a global meeting of over 80 stakeholders in Lagos, Nigeria in April 2025: Lessons Learned for the IPEA from Previous International Science Panels. A short summary of their deliberations, which includes the points we raise above, is available here https://verixiv.org/articles/2-280/v1. Final versions of the papers commissioned to brief the Lagos attendees are posted here: https://www.cgdev.org/project/building-amr-independent-panel-lessons-and-insights.

These comments were produced by the list of signatories below:

• Professor Iruka N. Okeke, PhD, University of Ibadan and Fellow, Nigerian Academy of Science
• Professor Kevin Outterson, JD,  Boston University
• Javier Guzman MD, MBA
• Dr M. Oladoyin Odubanjo, FISC, Executive Secretary, The Nigerian Academy of Science
• Robert Leo Skov, MD, ESCMID President
• Mathieu JP Poirier, PhD, York University
• Professor Clare Chandler, PhD, London School of Hygiene and Tropical Medicine
• Anthony McDonnell, MS, Centre for Global Development
• Ayodele A. Akinyele, PhD, University of Ibadan

See more details for each webinar in the “Events” tab.

Part 1: Beyond the Frontlines - Tackling AMR in Conflict and Crisis Zones (28 October 2025, 16:00-17:30 CET)

Part 2: Digital Tools and AI for Smarter Prescribing in Remote Areas (04 November 2025, 16:00-17:30 CET)

Part 3: It’s Not Just Bugs – It’s Us! The Intersection of Behavioural Science and AMR (11 November 2025, 16:00-17:30 CET)

Part 4: The Vaccine Dividend – How Immunization Can Be Used to Halt the Rising Burden of AMR (18 November 2025, 12:00-13:30 CET)

Fungal infections are an increasing global health threat, disproportionately affecting vulnerable populations—including patients with cancer, HIV, organ transplants, or those in intensive care. Mortality rates remain unacceptably high, yet diagnostic tools are often unavailable, especially in low- and middle-income countries, and treatment options remain limited. Alarmingly, only three antifungal drugs are currently in late-stage clinical trials, and diagnostic capacity falls far short of what is needed for timely and appropriate care.

Despite steady increases in recent years, antifungal resistance still receives limited attention within the broader antimicrobial resistance (AMR) agenda. This gap may have significant consequences in terms of morbidity, mortality, length of hospital stay, healthcare costs, and adverse outcomes.

To address this, the World Health Organization (WHO) has just published its first-ever reports on antifungal diagnostics and therapeutics—a landmark step that highlights both the urgency of the threat and the historical neglect of fungal pathogens. The WHO calls for enhanced global surveillance, greater investment in research, and stronger cross-sector coordination—including in agriculture, where fungicide use may drive resistance to clinical antifungals.

For ESCMID members, these reports represent a clear call to action: we must push for fungal infections to be fully integrated into AMR strategies, support innovation, and promote collaboration among clinicians, microbiologists, and policymakers.

Let’s ensure fungal infections are no longer the “neglected dimension” of AMR.

Written by: Antonio Vena (EFISG Educational Officer), Jon Salmanton-García (EFISG Chair), Valentijn Schweitzer (ESCMID AMR Action Communications Officer), Holger Rohde (ESCMID AMR Action Director)