AMR-related risks are a threat but also an opportunity for investors. Tying in with the UN General Assembly’s second-ever high-level meeting on antimicrobial resistance (AMR) in 2024, 86 investors representing US$13.9 trillion in combined assets have signed a statement urging governments and other policymakers to take action to tackle the global AMR crisis.
The Investor Action on AMR (IAAMR) statement outlines seven key recommendations that include science-based guidance, stewardship and equitable access to antimicrobials.
What are the biggest AMR-related risks to investors?
Antimicrobial resistance (AMR) is a threat to our health and that of animals and the environment. In addition, AMR also poses a systemic risk to our economy and investments, says Moana Nottage, a senior environment, social and governance (ESG) and sustainability analyst at Alphinity Investment Management in Australia.
In 2023, Ms Nottage published a report on the four biggest systemic risks of AMR. When microbes become resistant to treatment, then diseases become more severe and widespread. As AMR increases, it also threatens the effectiveness of new antimicrobial drugs.
As a result, many people end up sick, and we see a noticeable drop in productivity, an overburdening of the healthcare system and potentially an increase in tax rates to pay for these impacts.
Another AMR risk is its effect on food safety and security. “Awareness of AMR in the food supply chain is much lower than in human health,” says Ms Nottage.
Foodborne illnesses such as gastroenteritis affect consumers and food industry workers, disrupting the supply chain. The global nature of our supply chains means that AMR can easily spread across countries and regions.
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Good health and wellbeing support economic growth.
Moana Nottage
What are investor views on AMR within Australia?
From an investment perspective, AMR risks are a threat but also an opportunity for industry. “I think the threat of resistantance entering the ecosystems is going to be an increased focus in the Australian food sector,” says Ms Nottage.
For example, one of Australia’s largest food retailers, Woolworths, issued an antimicrobial stewardship policy in 2023. The company expects and encourages its farmed animal suppliers to use antimicrobials responsibly to minimise the risk of AMR.
In 2021, Alphinity joined the FAIRR Initiative, a global investor network focused on the ESG risks of intensive animal agriculture. FAIRR represents US$75 trillion in member assets under management, including Australian industry super fund HESTA.
We are becoming increasingly aware of the contribution of nature to our economy, health and wellbeing. Recently the Australian government has provided funding to the private sector-led, global Taskforce on Nature-Related Financial Disclosures (TNFD) framework, which includes AMR risk as a metric. “Since ecosystem health can be impacted by resistant disease, the broader focus on nature and biodiversity as important thematics could lift attention on AMR,” Ms Nottage explains.
It makes financial sense to focus on AMR risk. “Good health and wellbeing support economic growth,” says Ms Nottage. “We would encourage food and healthcare companies to have a strong AMR strategy underpinned by targets and metrics, similar to how we talk about climate change or physical safety.”
How can the IAAMR help?
The Investor Action on AMR (IAAMR) initiative is a collaboration between global investors focused on combating AMR. It was founded by the FAIRR Initiative, the Access to Medicine Foundation and the Department of Health and Social Care in the UK.
To tie in with the UN General Assembly’s second-ever high-level meeting on AMR in September 2024, the IAAMR and its investor members developed a statement that outlines seven key policy recommendations for global leaders to help combat AMR.
The IAAMR investors are pushing for a science-based AMR approach with defined targets to guide global action. The suggested approach is modelled on that of the United Nations Intergovernmental Panel on Climate Change (IPCC), which provides policymakers with regular scientific assessments on climate change, its implications and potential risks.
Tying in with this approach, investors are requesting a globally integrated surveillance system to keep track of levels of AMR and antibiotics use, enabling identification and reaction to any patterns.
“The statement represents the global investor voice at the UN high-level meeting,” says Suzi van Es, Investor Engagement Manager at the Access to Medicine Foundation.
The IAAMR statement: a ‘One Health’ approach
IAAMR investors are asking for a reduction in the use of antimicrobials in agriculture and animal farming, and responsible management of contaminated wastewater. The approach is labelled ‘One Health’, referring to collaborative and interlinked efforts across the human, animal and environmental health sectors.
The investor signatories are also calling on global policymakers to stop the use of antibiotics in animal farming for growth promotion and group prophylaxis. Furthermore, they are urging policymakers for sufficient funding to incentivise research and development of new antimicrobials and alternatives to antimicrobials.
Investors are requesting that policymakers ensure global equitable access to novel antimicrobials and alternatives, which could include a multilateral fund for financing provided to low-and middle-income countries.
“We encourage companies that are developing new products to already start thinking about access strategies and stewardship strategies early on in the clinical trial programme rather than waiting until after regulatory approval,”says Martijn van Gerven, Research Programme Manager for the Access to Medicine Foundation’s AMR Programme.
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The statement is so much more than just the seven asks that we detail. It is a tool to start a dialogue.
Suzi van Es
What happens next?
By early September 2024, ahead of the UN General Assembly’s AMR meeting, 80 investors representing over US $13 trillion in combined assets had signed the IAAMR statement. Since then, the number has grown to 86 signatories, with combined assets under management of US$13.9 trillion. Going forward, the investor group will convene round tables approximately every three months to discuss actions arising from the seven recommendations included in the statement.
“The statement is so much more than just the seven asks that we detail,” says Suzi van Es.“It is a tool to start a dialogue.”
Anja Becher is a Sydney-based freelance medical writer. She has more than 20 years’ experience writing across a wide range of health topics, including cardiovascular and respiratory medicine, metabolic diseases, gastroenterology and oncology.
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