Executive summary Investment in solutions to fight antimicrobial resistance in the Asia-Pacific could generate healthcare savings of $10-15 billion per year while cutting annual socio-economic costs by $35-40 billion. Antimicrobial resistance (AMR) is not just a looming health crisis – it is already a deadly reality, demanding urgent and coordinated global action. Globally, AMR was associated with approximately 4.71 million deaths in 2021, a figure projected to surge to 8.22 million by 2050, potentially surpassing cancer as the leading cause of death worldwide. This escalating crisis threatens to unravel decades of progress in modern medicine, turning treatable infections into potentially fatal conditions. The economic consequences are equally dire, with the World Bank warning that unmitigated AMR could wipe out between 1.1% and 3.8% of annual global GDP by 2050, disproportionately impacting low- and middle-income countries (LMICs). Asia faces a perfect storm of factors that exacerbate AMR, including limited healthcare infrastructure, unsustainable agricultural practices, inadequate sanitation and the impacts of climate change. Overuse and misuse of antibiotics – driven by unequal access to healthcare, insufficient capacity building and the availability of counterfeit drugs – accelerate the development of these “superbugs”. Additionally, Asia’s rapidly ageing population finds itself in the crosshairs, with deaths from AMR among the over-70s increasing by more than 80% from 1990 to 2021. This alarming trend highlights the imperative for urgent and coordinated action to tackle AMR in the region. In agriculture, the pressure to meet rising food demand leads to the rampant use of antibiotics in livestock farming, while improper aquaculture practices contaminate waterways. Widespread water insecurity and inadequate water, sanitation and hygiene (WASH) facilities further compound the problem, particularly in the face of climate hazards that disrupt sanitation systems and spread pollutants. To turn the tide against AMR, this report proposes a strategy built on three sprints and one marathon: 1 Sprint: Educate – Improve the knowledge and behaviour of clinicians, patients and farmers in responsible antimicrobial use and infection prevention. 2 Sprint: Prevent – Strengthen health systems and services by enhancing diagnostic capabilities and investing in WASH infrastructure. 3 Sprint: Monitor – Enhance regional surveillance, data collection and data sharing to improve monitoring and to inform policy. 4 Marathon: Treat – Invest in research and development (R&D) and increase access to novel and essential medicines. Philanthropy, investors and innovative financing can all play critical roles in supercharging these efforts. Within the next decade, investments in innovative AMR solutions in the Asia-Pacific are projected to generate potential healthcare savings of $10-15 billion per year, along with an additional $35-40 billion of annual savings in socio-economic costs. Ultimately, addressing AMR requires a whole- ecosystem approach, with concerted efforts and collaboration across sectors and borders to create a healthier future for Asia and the world. Targeted Action and Financing the Fight Against Antimicrobial Resistance in Asia 4

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