Written evidence submitted by Alliance for Reducing Antimicrobial Resistance
About the submitter
I am the Director of a UK non-profit organisation working to improve global access to effective antibiotics, particularly in low and middle income countries. My work involves supporting governments, multilateral organisations and industry to strengthen antimicrobial access, surveillance and stewardship. I have therefore seen directly how UK aid, especially through the Fleming Fund and the Global Fund, has shaped international health security.
The UK has been central to global health leadership for more than two decades. Two of its most important contributions have been the Fleming Fund and the Global Fund to Fight AIDS, Tuberculosis and Malaria. These investments have saved millions of lives, strengthened health systems, and served the UK’s own national and economic interests. Recent cuts to both funds now pose significant risks. They weaken systems that protect the UK from future pandemics, undermine progress against major infectious diseases, and reduce the UK’s credibility as a global leader in evidence-based health policy.
Antimicrobial resistance (AMR) is one of the most serious global health threats facing the UK. Drug resistant infections already cause an estimated 1.27 million deaths each year and threaten the effectiveness of modern medicine. Crucially, AMR grows fastest in settings with limited surveillance and poor laboratory capacity.
The Fleming Fund was created to address this exact problem. It strengthened diagnostic systems across Africa and Asia, established laboratory networks, improved data quality, and helped countries share information to identify emerging resistance patterns. This is work that no other donor has funded at comparable scale. The Fund did not solve every challenge, but it created a platform that the world could build on. Without it, global AMR surveillance will quickly deteriorate.
The decision to close the Fleming Fund will leave a large gap in the global AMR response. Many countries lack the resources to maintain laboratory capacity without external support. Others will lose technical expertise that took years to build. As a result, resistant infections may spread undetected until they reach crisis levels.
This creates direct risks for the UK. Pathogens do not respect borders and surveillance is our early warning system. If the world loses visibility of emerging resistance, the UK will detect threats later, face greater pressure on the NHS, and have fewer opportunities to contain cross-border outbreaks. Compared with the enormous economic and health impacts of uncontrolled AMR, the cost of maintaining the Fleming Fund is small. Ending it is therefore a strategic mistake that reduces both global and UK health security.
Alongside AMR, HIV, tuberculosis and malaria remain among the world’s leading infectious killers. The Global Fund has led the global fight against these diseases since 2002, saving an estimated 65 million lives. Its interventions are exceptionally cost-effective, averaging around 111 dollars per DALY averted. Independent research shows that even small increases in per-capita Global Fund spending produce measurable reductions in mortality.
The UK has been one of the Fund’s strongest champions and has shaped its accountability, procurement reforms and domestic health system investments. These contributions have given the UK significant global influence while delivering very high value for money.
Recent reductions in UK funding therefore undermine one of the most effective multilateral mechanisms we have. They also arrive at a dangerous moment. HIV progress has stalled, TB deaths have risen for the first time in years, and malaria cases are increasing in several high-burden countries. Global health financing from other donors is contracting at the same time. Weakening the Global Fund risks a return of preventable deaths and increased pressure on already fragile health systems.
The Global Fund also plays an important security function. Strong HIV, TB and malaria responses increase health system resilience against future outbreaks. Global Fund investments in laboratories, supply chains, community health workers and surveillance proved critical during COVID-19. Sustained support for this system is therefore an investment in pandemic preparedness.
Cuts to the Fleming Fund and the Global Fund diminish the UK’s global role at a time when international cooperation is essential. These institutions reflect some of the UK’s most successful contributions to the global good. They save lives at unmatched value for money, reduce the spread of high-risk pathogens, and strengthen systems that protect the UK.
Aid that supports disease control abroad reduces risks at home. When surveillance weakens or major disease programmes contract, outbreaks spread faster, travel restrictions increase, and the global economic system on which the UK depends becomes less stable.
The Fleming Fund and the Global Fund deliver exceptional returns for every pound invested. Their recent cuts undermine global health security, allow preventable diseases to resurge, and reduce the UK’s ability to influence the international system. As the UK considers the future of its development agenda, restoring funding for these mechanisms would demonstrate a clear commitment to protecting both global and British security.