Antibiotics and antimicrobials Antibiotics are a type of antimicrobials, which are drugs that treat infections caused by microorganisms. Antimicrobials can target bacteria, viruses, fungi and parasites, while antibiotics are only effective against bacteria. 1 AMR is now recognized as one of the greatest threats to health and development worldwide, contributing to about 9% of all global deaths.4 In 2021, bacterial AMR was directly responsible for 1.14 million deaths, claiming the lives of as many people as HIV/AIDS and malaria combined. If the issue is left unaddressed, deaths from AMR are projected to hit 1.91 million per year by 2050.5In 2021, the annual number of deaths associated6 with AMR totalled 4.71 million. If no imminent action is taken, this figure could almost double to 8.22 million,7 propelling AMR past cancer as the leading cause of death worldwide by 2050.8 1.1 The scale of the crisisThe global threat of antimicrobial resistance AMR was associated with around 4.7 million deaths in 2021. Without urgent action now, it could overtake cancer as the leading cause of death worldwide by 2050. The discovery of penicillin in 1928 by Alexander Fleming was a serendipitous moment that changed the course of history. As penicillin made its way to the frontlines of World War II, the impact was staggering – the mortality rate from bacterial pneumonia in soldiers plummeted from 18% to less than 1%.9 Penicillin did not just save lives on the battlefield; it revolutionized medicine for all. However, the misuse of antibiotics in healthcare, agriculture and everyday life has accelerated the natural process of bacterial evolution. AMR develops when bacteria, viruses or fungi adapt and no longer respond to medicines (antimicrobials) used to treat them. Globally, half of all antibiotic regimes are initiated without a clear diagnosis and employ the wrong drug.10 Unwitting misuse of antibiotics creates an environment where microbes thrive and multiply, creating “superbugs” that are resistant to the existing armoury of antibiotics. 1.2 The background Food meant to nourish and sustain has also become an unwitting accomplice in the spread of AMR. The use of antimicrobials in livestock and crop farming, which greatly surpasses antimicrobial consumption in humans, is creating a silent pandemic that finds its way onto dinner plates.11 As people consume antibiotic-laden foods, they ingest the invisible enemy. Even more alarmingly, up to 90% of these antibiotics are excreted back into the environment, seeping into the soil and freshwater, creating a vast reservoir of resistance everywhere.12 Penicillin didn’t just save lives on the battlefield; it revolutionized medicine for all. Targeted Action and Financing the Fight Against Antimicrobial Resistance in Asia 5

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