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Investors Make Case for Paris-like AMR Guidance

Statement urges global leaders to create a unifying set of “evidence-based steps” to tackle antimicrobial resistance.

Eighty global investors representing US$13 trillion in combined assets have renewed calls for global alignment in the fight against antimicrobial resistance (AMR), highlighting rapidly growing threats to human and animal health and the economy.

The initiative comes ahead of the UN General Assembly’s second High-Level Meeting on AMR, due to take place in New York at the end of this month.

“This September will see a High-Level Meeting on AMR [which] will be an opportunity for all sectors to mobilise together against this economic emergency,” said Dame Sally Davies, UK Special Envoy on AMR. “Investors have a crucial role to play to collectively chart a path forward to health, food and economic security. I call on all [of them] to join us in working across sectors to tackle the inter-generational AMR pandemic.”

Without substantial action, AMR-related treatments and productivity losses could cost US$412 billion and US$443 billion respectively each year by 2035, the investor coalition warned, while ten million human lives could be lost annually by 2050 – a figure rapidly raising from the 1.27 million recorded in 2019.

“With growing resistance, time is running out. You could even say we’ve run out of time,” Suzi Van Es, Investor Engagement Manager at the Access to Medicine Foundation (ATMF), told ESG Investor. “People need to be action-oriented. This is about us achieving right now – rather than mapping or understanding roles and responsibilities.”

Step by step

The call builds on a statement published in May that set out seven key asks considered “essential” to tackle systemic risks associated with AMR – emphasising the need for global cooperation, sustained funding, and innovative solutions.

“Because it’s not a well-trodden path, everybody’s going at it in their own way. We’ve tried to create a unifying set of evidence-based steps,” said Van Es. “Investors traditionally don’t always engage at the macro or multilateral level – certainly not in the absence of policies or guidelines. The statement is meant to amplify the role they could play at global-policymaker level.”

Investors involved in the statement know the common issues they’re grappling with, and have put forward their opinions to represent the industry at large on where priorities lie on AMR, Van Es explained. “This enables them to better understand and quickly get engaged on the issue, rather than creating their own data sets and analyses,” she added.

The call for global alignment is the latest of a series of actions led by the Investor Action on AMR (IAAMR) initiative – founded in 2020 by the ATMF, the US$75 trillion-backed FAIRR investor network, and the UK Department of Health and Social Care to galvanise investor efforts on the issue.

“AMR poses a serious threat to investment portfolios, economic stability, and global health,” said Maria Larsson Ortino, Senior Global ESG Manager and Health Lead at Legal & General Investment Management. “It’s encouraging to see a unified response from the investment community, reflecting a shared commitment to address this urgent challenge.”

Earlier this year, the UK government rolled out a five-year plan to combat AMR, pledging £85 million (US$112 million) to support the research and development of new antibiotics, improve global health infrastructure, and strengthen surveillance systems to accurately monitor threats.

“Despite the current lack of an international framework, awareness among policymakers is growing,” the investor call read. “In line with [our] statement, the UK and Saudi Arabian governments have called for an Intergovernmental Panel on Climate Change (IPCC)-style independent panel […] to monitor the future risks and impacts of AMR, and provide policymakers with regular scientific assessments to support decision-making and inform global targets.”

FAIRR and the ATMF recently partnered with the MSCI Sustainability Institute to publish an investor guide on AMR, outlining key systemic risks and investment considerations. The guide predicted losses of US$100 trillion in global productivity by 2050.

“The report found that almost 10% of global equity markets could be exposed to AMR-related risks, representing a little less than US$15 trillion,” said Emma Berntman, Senior Engagement Specialist at FAIRR. “The health impacts are expected to be higher in lower and middle-income countries, but it’s interesting to see that the investable company universe is more exposed in developed markets like the US and Europe.”

According to FAIRR, at least 20 shareholder resolutions have targeted AMR risks throughout global supply chains since 2020 – from pharmaceutical companies and livestock producers to food retailers and restaurants.

“The uncertainty that investors face needs to be better mitigated – we need to de-risk some of this at the multilateral or regulator level,” Van Es suggested. “We also need to better link up public policy funding to high and low-income countries towards a global coordinated response. Investors are uniquely placed, and can leverage their influence to safeguard society, economies and the long-term value of their portfolios.”

The fine print

Among the seven key asks, investors emphasised the importance of establishing science-based guidance and targets – contributing to the development of an international framework to guide sustained and cohesive action on AMR. This would allow them to set and monitor measurable actions and targets required of investee companies.

“If we look at how investors engage on climate change, the importance of having the same kind of guidance as the Paris Agreement or the Montreal Protocol on AMR is very apparent,” said Berntman. “This is completely lacking. Quantified and timebound goals would be extremely helpful from an investor perspective to understand ambition levels if progress is being made.”

Another crucial ask, Berntman insisted, is the ‘One Health’ approach – which considers the interplay between animal, human and environmental health.

“AMR is a complex issue, and to address it we have to consider how antibiotics are used on all sides – human, animal, and their presence in the environment,” she added. “All stakeholders need to be involved – on the governmental level, regulators, corporates, financial institutions, but also the man on the street.”

The statement also insisted on the importance of stewardship, encouraging global policymakers to commit to reducing the use of antibiotics in agriculture and adopt legislation to set maximum limits for antibiotics residue in wastewater from manufacturing facilities. In addition, it highlighted the need to create a globally integrated surveillance system for AMR and antibiotic use.

“While GLASS [Global Antimicrobial Resistance and Use Surveillance System] and ANIMUSE  are excellent surveillance systems, not all countries feed into it,” said Berntman. “We don’t have full clarity on where multi-resistant bacteria have developed, and the exact health implications for both humans and animals. As such, the integrated surveillance system will be really important – together with the IPCC-style panel.”

Although she welcomed the high level of support garnered for the statement and growing awareness in the investor community, Berntman pointed to a “huge need” for further education and upskilling around AMR.

“But that’s true for all new topics that come onto an investor’s agenda,” she acknowledged. “If we go back 5-10 years, how many were working in a consistent manner on nature loss?”

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