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

Enhance diagnostic capabilities for surveillance and targeted treatment prescription Asian communities, especially the most underserved, need access to low-cost, rapid and accurate diagnostics. Diagnostics are vital in the fight against AMR, as they help identify the specific infectious agent causing an infection and determine which antimicrobials are most likely to be effective against it, allowing for the selection of the most appropriate treatment option. It is also important to note that existing analyses and forecasts on the burden of AMR are dependent on available data. The accuracy of these forecasts is compromised by scarce, fragmented, under- sampled or non-representative data, including a lack of data from medically underserved populations.117 According to QJS’s first biennial report, “AMR rates and trends are difficult to interpret in most LMICs due to insufficient testing coverage and weak laboratory capacity.”118 However, conventional methods of antimicrobial susceptibility testing (AST) tend to be labour- intensive and expensive,119 with a turnaround time of at least 48 hours. New forms of AST – including pioneering advancements in the field, such as whole genome sequencing (WGS), advanced spectroscopy and microfluidics technology – are costly techniques that require significant investment upfront. Meanwhile, multiple iterations of diagnostics are often needed to investigate the exact pathogen that is causing the infection, which can cause overall healthcare cost to increase significantly. For example, according to Manipal Hospitals, it costs around Rs 70,000-100,000 ($ 800-1,150) per day to test and treat a patient with sepsis. In contrast, supportive care only would cost around Rs 50,000 per day. While diagnostic tests are included under health insurance, most patients in India – especially if they reside in Tier 2 cities and below – are not covered by either public or private insurance and are ill-able to afford the extensive diagnostics required to identify the cause of infection as well as the corresponding treatment. Much work is needed to get to a diagnosis that is cheap enough and simple enough to be used in the field and at the point of care. Equipping a laboratory with a full suite of AST capabilities requires large capital expenditure and a constant supply of energy and water – as well as skilled talent that may not be readily available in rural parts of Asia. Within South-East Asia, there is heavy reliance on a handful of reference laboratories that can conduct “gold-standard” testing. However, during the COVID-19 pandemic, some countries were able to decentralize their test load to trained laboratories at the sub-national levels, reducing the turnaround time for testing. More investment and support for laboratory accreditation and standardization would improve diagnostic testing capacities across South-East Asian countries.120 Diagnostics rely heavily on consistent, reliable imports of laboratory supplies and equipment, such as chemical reagents and consumables. One way to enhance diagnostic capabilities would be to strengthen supply chains of these consumables across Asia. However, in South-East Asia for example, while some countries maintain small stockpiles of medical supplies, none seem to have diagnostics stockpiles or a system that enables them to have rapid, sustained and reliable access to reagents and other diagnostic supplies.121 In building supply chain resilience, there is merit in building up national or regional diagnostic supply stockpiles to ensure that diseases can always be accurately identified in times of both peace and crisis.This sprint involves boosting preventive measures, such as improving diagnostic capabilities including technologies for antimicrobial susceptibility testing (AST) and investing in better WASH measures.Strengthen health systems and services Much work is needed to get to a diagnosis that is cheap enough and simple enough to be used in the field and at the point of care.Sprint: Prevent 2 27 Targeted Action and Financing the Fight Against Antimicrobial Resistance in Asia