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

Pool resources to ensure sufficient antimicrobial supply across Asia Efforts to address the market infrastructure for antibiotics focus on overcoming economic barriers that hinder their development and distribution. Initiatives include incentivizing pharmaceutical innovation through public-private partnerships, subsidies and pull mechanisms such as market- entry rewards. Strengthening supply chains and regulatory frameworks ensures equitable access to quality antibiotics while preventing counterfeit drugs too. These measures aim to create a sustainable market that supports innovation, availability and responsible use of antibiotics globally. As funding for development of new drugs grows, it is essential to tie finance for product development to access conditions. Donors could require developers to register and supply novel or essential antibiotics in high-burden countries within a set time frame or provide sub-licences to organizations that can distribute them. Beyond these conditions, investments in pooled procurement systems, not-for-profit partnerships and innovative financing – models that have proved successful in other global health areas – can ensure broader access.153 Addressing the growing threat of AMR requires innovative funding models that balance the needs of public health, equitable access and sustainable development. The following three funding mechanisms showcase diverse and impactful approaches to tackling AMR globally. Together, they pave the way for a more collaborative, equitable and effective global response to one of the most pressing health threats of our time. As funding for development of new drugs grows, it is essential to tie finance for product development to access conditions. FUNDING MECHANISM 1 Subscription model, e.g. UK National Health Service In 2024, the United Kingdom’s National Health Service (NHS) launched the NHS antimicrobial products subscription model. This innovative scheme pays pharmaceutical companies a fixed annual fee for antimicrobials, “based primarily on a health technology assessment of their value to the NHS, as opposed to the volumes used”. In this way, the model de-links revenue generation from the quantity of antibiotics prescribed, thereby removing the incentive for companies to encourage the over-prescription of antimicrobials to bring in returns.154 According to the NHS, it is the first health system in the world to try this approach. Often, pharmaceutical companies deprioritize the development of new antimicrobials due to a lack of certainty around funding commitments and market demand,155 given how hard it is to predict where the next wave of infection might happen and when antimicrobial treatment might be needed. The principle of antimicrobial stewardship also restricts the use of the latest antimicrobials except when absolutely needed. However, the NHS’s subscription model tackles this challenge by providing an assurance of guaranteed returns for effective new antimicrobials through a fixed annual subscription fee. Source: See endnote.156 According to the Clinton Health Access Initiative (CHAI), a significant barrier for new medicines lies in the regulatory process. Innovation for newer drugs tends to be in higher-income countries where there are more resources and funding available. This leads the product developer to register their product for regulatory approval in these countries rather than elsewhere. Even if the patent is waived or expires, generic drug manufacturers are not able to produce the same drug in other countries where regulatory approval has not already been obtained. Without a reference product, generic manufacturers may need to conduct clinical trials all over again to obtain regulatory approval – an often tedious and costly process that can delay drug access for the rest of the world.157 Equally, it is dangerous to assume that generic manufacturers could produce such new drugs in the first place – given the lack of knowledge transfer, shortage of raw materials and insufficient capacity that continue to impede the manufacture of these life-saving, innovative drugs for the communities that need them the most.158 Targeted Action and Financing the Fight Against Antimicrobial Resistance in Asia 34