In May 2026, the World Health Assembly will consider adoption of an updated World Health Organization (WHO) Global Action Plan on AMR (GAP). The initial action plan, adopted in 2015, has enabled significant progress against antimicrobial resistance (AMR) over the past decade, including the introduction of critical WHO programmes such as the Priority Pathogen List and the development of comprehensive National Action Plans by Member States, in addition to giving rise to the creation of GARDP.  

Efforts are now underway to update the GAP, with WHO inviting feedback on a zero draft. This process represents a significant opportunity to transform the 2024 UN Political Declaration on AMR into tangible, equitable outcomes. GARDP urges global leaders to consider four critical areas: (1) access to antibiotics; (2) focus on children and newborns; (3) the role of non-profit public-private partnerships; and (4) financing the global AMR response. 

Access to antibiotics 

The initial GAP did not include a focus on access to antibiotics, and instead only elaborated measures to reduce antimicrobial use and promote stewardship. This was a critical omission. 

There is evidence of lack of access to antibiotics today, especially in low- and middle-income countries. A study published this year and co-authored by GARDP found that across eight diverse and populous low- and middle-income countries, less than one 1 in 15 people with multidrug-resistant infections are receiving the right treatment because of lack of access to diagnostics and antibiotics, weak health systems and gaps in treatment pathways.  

Improving equitable access could significantly reduce the AMR burden, preventing more than 50 million deaths by 2050. The updated GAP should strengthen its approach to access. It should underscore the importance of integrating access-related considerations into R&D. Furthermore, access-related interventions should be tailored to diverse contexts, such as the level of economic development, the setting (rural or urban) and the presence of natural disasters or conflict. 

Focus on children and newborns 

The zero draft of the updated GAP does not include a focus on children and newborns. Children and newborns face one of the highest disease burdens due to AMR, accounting for one out of every five deaths. Children and newborns are particularly vulnerable to infections, especially those living in poverty. Yet this group often lacks access to treatment, due in large part to the decade-long delay in adapting and relabelling new and existing treatments for the benefit of children. The updated GAP should highlight the needs of this disproportionately affected population group.  

The role of non-profit public-private partnerships 

The zero draft of the updated GAP does not recognize the critical role of non-profit partnerships in the AMR response. We note the complementary role that GARDP and CARB-X play in working with partners across the public and private sectors to strengthen and facilitate R&D and access to antibiotics.  

Since its establishment in 2018, GARDP has taken a leading role in public-health-driven antibiotic R&D and access, notably completing the first phase 3 trial sponsored by a non-profit organization for an antibiotic, and engaging in pioneering license agreements to integrate access-related considerations into antibiotic development and expand access in high-burden countries. GARDP has also become a leading advocate and partner in advancing children’s antibiotics through its global observational study involving 3000+ newborns and its ongoing international trial to identify and rank safe new empiric treatment regimens for contexts of varying levels of antibiotic resistance.  

GARDP maintains that the updated GAP should recognize the importance of a non-profit public-private approach to developing and delivering antibiotics for neglected populations at a global scale.  

Financing the global AMR response 

The current financing proposals in the zero draft of the updated GAP are inadequate to respond to the scale of the AMR health crisis. Many countries are currently facing debt crises, economic decline due to tariffs, and reduced foreign assistance. In this context, financing is needed to support appropriate clinical development for high-burden populations as well as specific populations, such as children and newborns. Financing should also go towards the catalytic procurement of antibiotics and boosting the capacity of countries to provide appropriate treatment. In addition to strengthening the healthcare workforce, funding should support local or regional production of needed treatments and the expansion of diagnostic capacity.  

The initial GAP represented a significant step forward in the global AMR response. GARDP welcomes the opportunity to help shape the updated Global Action Plan, and we look forward to working with WHO, our partners, and the wider AMR and health community to address the AMR crisis collectively.