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

FUNDING MECHANISM 2 Sub-licensing for LMICs, e.g. GARDP , CHAI and Shionogi In 2022, the Global Antibiotic Research and Development Partnership (GARDP), the Clinton Health Access Initiative (CHAI) and Japanese pharmaceutical company Shionogi signed a licence and technology transfer agreement to enhance access to cefiderocol, an antibiotic used in the treatment of certain serious, resistant bacterial infections among adults. While cefiderocol is part of the WHO’s Essential Medicines List, access to this antibiotic remains lacking in LMICs. Under the agreement, GARDP sought to obtain a sub-licence from Shionogi to unlock rights and manufacturing know-how. CHAI’s role was to identify suitable manufacturers to bring into the project as sub-licensees. Thereafter, if any of these manufacturers made a request for a technology transfer, Shionogi would share details of manufacturing processes and relevant know-how with the sub-licensee. By providing proper technology transfer, the issue of counterfeit or substandard drugs could be averted. Through this partnership, the licensed territories offering access to cefiderocol expanded to 135 countries (70% of all countries), encompassing a significant proportion of people affected by AMR. To support affordable access to cefiderocol even further, Shionogi waived its cost recoupment fees on net sales of the drug in LMICs within the licensed territory. Sources: See endnote.159 Beyond funding or licensing from pharmaceutical companies directly, there is merit in exploring other models or channels to increase access to antimicrobials. Additionally, investing in building market infrastructure in Asian countries, where commercial support for novel antibiotics and diagnostics is limited, would expand access to these crucial tools. Strengthening these markets would ensure that innovations in AMR reach both high- and low-income countries, especially in regions such as Asia, where the AMR burden is significant.160 FUNDING MECHANISM 3 Testbed of new ideas and models, e.g. The Trinity Challenge on Antimicrobial Resistance The Trinity Challenge supports the creation of data-driven solutions to help protect against global health threats. Launched in response to the COVID-19 pandemic and funded by diverse stakeholders across academia and philanthropy, the challenge seeks to support data-driven solutions that can help the world prepare for and respond to global outbreaks and health emergencies. While its first edition focused on pandemic preparedness and response, the following two focused on AMR. The second edition of The Trinity Challenge, launched in 2024, called for solutions that address the threat of AMR, specifically antibiotic resistance in bacteria. In all, 285 solutions from 57 countries were received, which included ideas on developing new capabilities and tools to collect and use data from community settings, and optimizing the use of citizen-related data and LMIC data to inform action and policy for tackling antibiotic resistance at local, national and regional levels. The third edition, launched in February 2025, focuses on “community access to effective antibiotics” and calls for solutions to manage antibiotic stock control. The challenge prioritizes solutions relevant to LMICs, given that substandard and falsified antibiotics are estimated to make up 10% of antimicrobials used by humans161 and 6.5% of veterinary medicines across these countries.162 Sources: See endnote.163 There are many areas for intervention across the AMR value chain. However, none of these interventions is the sole responsibility of any one funder – rather, funders are needed across the spectrum of capital to join forces and participate in innovative models to close the funding gap for AMR. The traditional strategy of antibiotic stockpiling can be a stop-gap measure when infection occurs, but preventing the infection in the first place would prove a more effective strategy with longer-term pay-offs. Although different funders may have their own objectives, horizons and metrics of success, it is worthwhile for them to engage in open conversation and align with one another to launch a coordinated response to the threat of AMR. Ultimately, substantial and sustained funding, with everyone playing their part, is crucial to ensure there is sufficient end-to-end financing. A summary of the proposed solutions across the AMR value chain is presented in Figure 10. Targeted Action and Financing the Fight Against Antimicrobial Resistance in Asia 35