AMR is not a standalone issue – it jeopardizes many advances in modern medicine. It complicates the treatment of infections and increases the risks associated with medical procedures and treatments, including surgeries, transplants, intensive care and caesarean sections.13 It threatens the health of people with weakened immune systems, such as cancer patients, for whom a simple infection can be lethal. Hospital-acquired infections and sepsis14 are exacerbated by AMR – of the 21.36 million deaths attributed to sepsis worldwide in 2021, 22% were associated with AMR and 5% were directly attributable to AMR.15 Common diseases that have traditionally been treated with antibiotics, such as urinary tract infections (UTIs), are becoming increasingly difficult to treat due to AMR. A study conducted in 2021 found a high prevalence of resistance (up to 90%) against four of the most commonly used antibiotics used to treat UTIs – with significant levels of AMR reported in Bangladesh, India, Sri Lanka and Indonesia.16 The impact of AMR also extends to agriculture and the environment. The World Bank projects that by 2050, global livestock production could decline by between 2.6% and 7.5% per year due to AMR.17 Another study by the World Organisation for Animal Health (WOAH) estimates that current resistance rates could lead to losses of 0.84% in the production of cattle milk, 2.05% losses for chicken meat and 0.92% for pork production.18 The misuse of antimicrobials continues to contaminate ecosystems and waterways. Freshwater serves as the main reservoir for antimicrobial-resistant bacteria in South-East Asia.19 In Malaysia, 40% of Escherichia coli (E. Coli) and Salmonella isolates tested in drinking water treatment plants were found to be multidrug-resistant.20 AMR is not just a public health crisis – it is an economic threat. If the world does not act, AMR threatens to wipe more than 5% of annual GDP from the economies of low- and middle-income countries by 2050.21 AMR threatens to wipe more than 5% of annual GDP from the economies of low- and middle-income countries by 2050. 1.3 Not just a health issue Targeted Action and Financing the Fight Against Antimicrobial Resistance in Asia 7

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