Reflections from developing a Fleming Fund Learning Product on making the economic case for AMR surveillance

Antimicrobial resistance (AMR) surveillance is widely recognised as a cornerstone of preventing, detecting and responding to AMR. The WHO Global Action Plan identifies strengthening AMR surveillance and research as a core objective, and many low- and middle-income countries continue to build AMR surveillance systems through National Action Plans (NAPs), donor support and domestic financing. Yet when budgets tighten and priorities compete, AMR surveillance can still struggle to make the shortlist.

Why?

This question sat at the centre of a recent Fleming Fund Learning Product developed by LAMP Development, exploring the limitations of current approaches to estimating the value of AMR surveillance and strengthening the investment case. The process was not simply about reviewing economic studies. It became an opportunity to reflect on how we talk about AMR surveillance, what we value, and why some investments are easier to justify than others.

One observation emerged quickly: AMR surveillance may be undervalued, not due to a lack of benefits, but because current approaches do not fully capture, evidence or communicate the scope of benefits it can generate.

Unlike medicines, vaccines or service delivery interventions, AMR surveillance does not always produce benefits that are immediate, visible or easily attributable. Its value lies in generating data that can inform treatment guidelines, stewardship programmes, infection prevention and control, food safety measures, outbreak response and policy decisions. Many of the benefits that follow, such as earlier outbreak detection, improved laboratory efficiency, reduced response costs and productivity gains across animal health and food production systems, often emerge over time, span sectors and depend on decisions made by multiple actors. When the links between AMR surveillance data, decision-making and action are not well recognised, investments may be deprioritised, data underused, and inaction can prevail. As a result, conventional economic evaluations may not always fully reflect the breadth of benefits that AMR surveillance can generate.

Developing the Learning Product also prompted reflection on what this means in practice for those responsible for designing, prioritising and financing AMR surveillance. As National Action Plans (NAPs) mature and resources tighten, questions around AMR surveillance design, sustainability and value are likely to become increasingly important: What is the minimum amount and type of data needed to support action? What AMR surveillance functions should be prioritised when resources are constrained? How can AMR surveillance investments be better linked to stewardship, IPC, and other interventions to demonstrate broader value?

This Learning Product seeks to support country-level decision-makers, planners, economists, technical analysts and partners involved in designing, strengthening and financing AMR surveillance systems. Drawing on Fleming Fund learning and existing evidence, it presents a Menu of Quantifiable Benefits that can be adapted to country contexts when developing investment cases, prioritising NAP activities and communicating the value of AMR surveillance across sectors.

Perhaps the most important lesson is that making the economic case for AMR surveillance should not be an afterthought. AMR surveillance systems, approaches for evidencing their benefits and investment cases are likely to be strongest when they are shaped together from the outset.

You can read the Learning Product by clicking here.