WAAW 2025: Global South priorities are key for an equitable Global AMR Action Plan

World Antimicrobial Awareness Week (WAAW) 2025 will take place from November 18 to 24, 2025.

In the lead-up to shaping the draft Global Action Plan on Antimicrobial Resistance (AMR), the Delhi-based think tank Centre for Science and Environment (CSE) convened a consultation to gather the priorities and perspectives of diverse stakeholders across the Global South. The meeting brought together public health experts, scientists, policymakers, civil society groups, and representatives from the animal health and environmental sectors, creating a platform to articulate shared concerns and propose concrete solutions for a more equitable global AMR framework.

A clear and consistent message emerged from the discussions: the Global Action Plan must move beyond its historic emphasis on stewardship and surveillance to embed strong, enforceable obligations on equitable access. The previous Global Action Plan placed significant focus on responsible use but did not create binding commitments to ensure the availability of essential antimicrobials.

National Action Plans have reproduced this imbalance, often prioritising the control of excess use while overlooking the critical challenge of insufficient access to, and supply of, vital Watch and Reserve antibiotics across low- and middle-income countries.

Shortages and stock-outs of antibiotics and diagnostics, especially at the primary health-care level, were identified as major barriers. Participants urged stronger national mechanisms to monitor and prevent supply disruptions and called for addressing market failures, particularly for older, less commercially profitable antibiotics, through pooled procurement models such as the SECURE initiative and regional supply arrangements to stabilise supply and improve forecasting and quality assurance. 

The SECURE initiative is a joint effort by the World Health Organization (WHO) and the Global Antibiotic Research and Development Partnership to address AMR.

Universal health-care systems, supported by strong legislation, were identified in the meeting as essential for closing access gaps. Participants stressed that access gaps are particularly acute in fragile, conflict-affected, and resource-limited settings, where humanitarian blockades restrict the flow of medical supplies, including lifesaving antibiotics.

Across discussions, stakeholders emphasised the need to treat antibiotics, diagnostics, vaccines, and related AMR tools as global public goods. Ensuring affordability and availability must be central to publicly funded R&D initiatives. Public financing for the research and development of antibiotics, tests, and vaccines must also incorporate downstream access and knowledge-sharing conditions so that innovations supported by public funds translate into products that are available and affordable to health systems and patients.

Another priority raised was the need for vaccines that reflect regional epidemiology and health priorities, an area where the current R&D ecosystem remains insufficiently responsive to Global South needs. Participants also pointed to the persistent lack of reliable data on access barriers, which undermines evidence-based policymaking.

Member states need to consider that operational research on access and equity, particularly for diagnostics, is urgently needed, as weak diagnostic capacity continues to fuel irrational antibiotic use. Strengthening diagnostic systems emerged as essential. Stakeholders called for the updated Global AMR Action Plan to require member states to adopt the WHO Essential Diagnostics List (EDL) and integrate it into procurement systems and public-health supply chains.

Strengthening national drug regulatory authorities was recognised as another critical priority for member states. Substandard antibiotics continue to undermine treatment outcomes and accelerate resistance. Ensuring the consistent availability of quality-assured medicines must therefore be a cornerstone of the revised Global Action Plan.

High prices of health technologies were also highlighted as structural barriers to access. Stakeholders encouraged member states to adopt policies that curb monopolies, encourage competition, and leverage industrial policy to support domestic innovation and affordability.

However, emerging funding shortages, including reductions in international financing, threaten the implementation of National Action Plans. Participants urged governments to mobilise domestic resources and secure long-term financing pathways.

Crucially, the discussions emphasised that AMR cannot be addressed without fully integrating the veterinary sector. Ensuring farmers’ access to free, quality veterinary services and publicly funded veterinary antibiograms is key to guiding responsible antimicrobial use in animals.

The consultation reflected a wide spectrum of institutional and geographical perspectives. Public health authorities contributed insights from national bodies in Oman, the Philippines, and Tanzania. Regional and international expertise came from organisations working across Asia, Africa, and the Eastern Mediterranean. The veterinary and livestock sectors provided grounded field perspectives from East and West Africa, while civil society and public health experts from India and across Africa emphasised community-level challenges. Global policy coherence was ensured through contributions from the WHO’s AMR Division, anchoring national and regional challenges within the broader global agenda. 

Together, these diverse voices underscored the urgent need for a Global Action Plan that is grounded in equity, aligned with the realities of the Global South, and capable of delivering meaningful, measurable change in access to life-saving AMR-related health technologies.

Leena Menghaney is a lawyer with over two decades of experience working at the intersection of public health, intellectual property, and pharmaceutical policy. Views expressed are the author’s own and don’t necessarily reflect those of Down To Earth