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Funding remains one of the largest barriers to tackling AMR effectively. Although many nations have developed AMR action plans, few have secured the resources to implement them comprehensively. The UN declaration calls for $100m to help achieve a target of at least 60% of countries having funded national action plans on AMR by 2030.2 This raises a sobering question: what happens to the remaining 40% of countries, particularly the low and middle income countries where AMR is projected to hit hardest? Many countries facing the greatest threat from AMR may remain unsupported. This is a problem because microbes know no borders. If we are serious about tackling AMR, we cannot afford half measures. Unless every country is equipped to confront this crisis, we all stand to lose.

Another issue is expanding access to diagnostic tools. Without effective diagnostics, antibiotics are often prescribed based on symptoms without precise bacterial identification. This leads to unnecessary and ineffective prescribing, which then drives resistance. The UN declaration called for action on diagnostics, and here the approach must be ambitious. The recent WISH report on AMR calls for countries to commit to ensure that by 2030 antibiotics are prescribed only when a diagnostic test confirms the need.3 Achieving this will require fundamental shifts in medical practice and new pathways of care. It will also require substantial investment in technology and life sciences. But these steps will enable the use of the right drug for the right bug. This approach will also need to consider equitable access. While some countries grapple with overprescription of antibiotics, others struggle with limited access to life saving treatments. These inequities compound the AMR burden, and so access to diagnostics must be seen as a matter of global equity.

Even the best funded efforts will falter without public engagement. Tackling AMR requires a grassroots movement, one that involves public education, awareness campaigns, and citizen participation in research and policy development. AMR is not just a healthcare issue; it is detrimental to economies, societies, and humanitarian efforts worldwide. It is influenced by both individual and systemic behaviours. All countries must engage their citizens in tackling AMR, with clear plans to do so by 2028. Education is the first step, as knowledge is one of the most powerful drivers of behaviour change. Studies show that AMR awareness among healthcare staff has contributed to reduced antibiotic prescribing and better stewardship practices.3 However, the NHS found that, while courses are available to provider trusts, only 35% of organisations actively promoted the course and sessions to staff.4 Public involvement can drive meaningful change. We have seen this influence with climate change, another global crisis linked to AMR. A shift in AMR awareness can help create a society where responsible antibiotic use is second nature.

We must move faster, pushing for action, including dedicated funding, accessible diagnostics, and an informed, engaged public. That’s why I am honoured to chair the Fleming Initiative, which aims to build a global movement to protect humanity from the growing threat of drug resistant infections.5 The Fleming Initiative will bring together policy makers, industry, researchers, and the public to safeguard antibiotics for future generations. We must act now—while we still can prevent AMR escalating and changing the course of modern medicine.