Targeted Action and Financing the Fight Against Antimicrobial Resistance in Asia 2025

Asia – The perfect crucible to incubate AMR FIGURE 5 Limited healthcare infrastructure Unequal access to healthcare Millions lack access to quality healthcare and universal health coverage is insufficient. Lack of prevention Risk of hospital-acquired infections is ~2-20x higher in the Asia-Pacific. Insufficient vaccination increases this risk. Skills shortage Lack of skilled healthcare practitioners and technical capacity leads to weak AMR monitoring and stewardship. Counterfeit drugs Rampant use of counterfeit or low-quality antibiotics undermines treatment, increases resistance and erodes trust in health systems. Misuse of antibiotics Antibiotics are misused and overused due to a lack of understanding, ineffective regulations, inadequate monitoring and absence of dedicated stewardship programmes.Unsustainable agriculture and aquaculture Rising food demand More intensive livestock production increases the amount of antibiotics use throughout the food chain, as farmers overuse/misuse antibiotic to treat illness, prevent disease and promote growth. Contamination of waterways Rising sea temperatures increase mortality of aquatic animals, prompting farmers to increase prophylactic use of antimicrobials. Resistant fungi Widespread use of fungicides in crop protection encourages more resistant strains of fungal pathogens in the environment. Inadequate clean water and sanitation Lack of adequate WASH facilities 75% of Asia’s population faces water insecurity. Fewer than 40% of healthcare facilities in LMICs have even rudimentary water, sanitation and hygiene (WASH) amenities. Impact of climate change WASH infrastructure can be compromised by climate-driven hazards (e.g. floods, droughts). While the broader risk factors of ageing populations and climate change discussed above are not easily addressed at a national level, this section presents risk factors relating to human activities – including healthcare, agriculture and sanitation – which can be controlled and addressed more locally. The combination of challenges arising from Asia’s limited healthcare infrastructure, unsustainable agriculture practices and inadequate sanitation creates the perfect crucible for the proliferation of AMR (see Figure 5). As a consequence, South Asia and South-East Asia are home to the highest number of major bacterial pathogens for which there is AMR.56 Limited healthcare infrastructure Several challenges in Asia’s healthcare systems exacerbate the AMR crisis, such as unequal access to healthcare; lack of appropriate infection prevention, control and vaccination programmes; rampant availability of counterfeit and substandard drugs; and overuse and misuse of antibiotics.Unequal access to healthcare Millions of people in Asia lack universal health coverage. This affects individual health outcomes but also contributes to the spread of resistant pathogens within communities. In India, for example, the combination of a high burden of disease, poor public health infrastructure and cheap, unregulated antibiotics has created an ideal environment for resistant infections to thrive.57 Lack of appropriate programmes for vaccination, and infection prevention and control The risk of hospital-acquired infections (HAIs) is estimated to be two to 20 times higher in the Asia-Pacific region, with up to 25% of hospitalized patients reported to have acquired infections.58 Lack of high-quality evidence and data impedes the enhancement of infection prevention and control practices, while gaps in education, organizational and cultural barriers, infrastructure, fiscal resources and key leadership continue to obstruct the implementation of infection prevention and control measures as a core component of patient safety programmes across the region.592.3 The factors influencing AMR in Asia South Asia and South-East Asia are home to the highest number of major bacterial pathogens for which there is AMR.Source: Centre for Impact Investing and Practices (CIIP). Targeted Action and Financing the Fight Against Antimicrobial Resistance in Asia 15