Tackling AMR: the critical role of vaccines and health surveillance systems

By a.tacu, on 27 August 2025

Authors: Anca Tacu, UCL STEaPP Policy Impact Unit; Salomé De Sa Magalhaes, UCL Biochemical Engineering; Colin Brown, UK Health Security Agency; Marcello Gelormini, WHO Regional Office for Europe; Duygu Dikicioglu, UCL Biochemical Engineering; Patty Kostkova, UCL Department of Risk and Disaster Reduction

10th Digital Public Health Conference (DPH 2025) panellists on stage

Context: At the end of July, VaxHub Global and VaxHub Sustainable, together with the UCL Policy Impact Unit brought together expert voices from the World Health Organization (WHO), the UK Health Security Agency (UKHSA) and UCL at the 10^th Digital Public Health Conference (DPH 2025) in Madeira to explore how vaccine innovation and health surveillance systems can help to tackle antimicrobial resistance – one of the most pressing public health threats of our time.

Antimicrobial resistance (AMR) is a rapidly growing public health threat directly responsible for 1.3 million deaths annually, with projections showing over 39 million people could die from antibiotic-resistant infections by 2050[1]. In the UK alone, over 35,000 lives are lost each year due to infections that no longer respond to treatment and this number is predicted to increase to 184,000 by 2050 [2][3]. Without immediate action, AMR will not only pose an increased risk to people’s lives, but it will also have severe social and economic consequences, leading to global annual GDP losses of $1.7 trillion over the next 25 years[4]. Despite its clear urgency, AMR remains under-prioritised, underfunded and technically constrained, especially in places where the threat is most acute.

At the heart of the problem lies a paradox: we know AMR is a growing threat, but we lack the tools to track it and address it effectively. Diagnostic technologies to inform the right treatment are expensive, and often inaccessible in low- and middle-income countries (LMICs), where resistant infections are most prevalent.

In this context, cuts to overseas aid funding, like the recent scrapping of the Fleming Fund – through which UK supported LMICs to take action against drug resistance through improved surveillance systems and capacity-building – have been strongly criticised for being short-sighted and weakening long-term efforts to tackle this global crisis.

Strengthened AMR surveillance systems are crucial for identifying and assessing the spread of AMR; if we don’t measure the problem, we can’t manage it effectively. Collaborative efforts like the CAESAR network, EARS-Net and the Global Antimicrobial Resistance Surveillance System (GLASS) have helped to harmonise data collection and create a clearer picture of resistance patterns and trends. By making AMR more measurable and reportable, surveillance can help to tell us not only where to act but also how prevention strategies like vaccinations can ease the burden on resistance.

Vaccines are a powerful yet underappreciated tool in combatting AMR. Vaccines reduce infections and antibiotic use by preventing the infection from happening in the first place, which limits opportunities for resistance to develop. Strategic investment in vaccines could reduce global antibiotic use by up to 22%, avoiding 2.5 billion daily doses every year[5]. Nonetheless, historical overreliance on antibiotics has narrowed our response options to fight infections, and alternatives to antibiotics, including vaccines, have not benefitted from adequate investment.

So why do vaccines remain overlooked when it comes to AMR? This is a multifaceted issue; to start with, vaccines against AMR suffer from a conceptualisation issue. Vaccines are usually associated with protecting from viral illnesses whereas vaccines against bacterial illnesses are mainly seen in connection to childhood diseases (e.g. pneumococcal vaccine). It is challenging to articulate the need to have vaccines later in life which prevent against drug-resistant bacteria causing illnesses which may not be perceived as a significant risk by most people (e.g. bacteria that causes a persistent urinary tract infection).

Another difficulty is the development and manufacturing of vaccines against bacteria causing the most critical illnesses (e.g. E. coli) due to several reasons including diversity of strains, additional precautionary measures needed when undertaking AMR research and the need to find the right groups of people to carry out clinical studies.

These challenges are amplified by increased vaccine hesitancy fuelled by social media misinformation, which has put at risk the success of vaccines in preventing diseases. At the same time, not enough has been done to counter vaccine hesitancy by public health professionals and scientists.

Harnessing Innovation and Collaboration to Tackle AMR

AMR knows no borders. Resistant pathogens travel with people, goods, and animals. Weakening global surveillance and response mechanisms poses a direct threat to the NHS, to national and global public health, and to the safety of future generations. To effectively confront complex public health challenges like AMR, we must embrace a comprehensive approach which combines technological innovation with public engagement, institutional capacity and political will.

Health surveillance systems are foundational. They enable us to quantify and monitor threats, making the role of tools like vaccines more visible and helping to overcome the “paradox of prevention”, where success leads to complacency. Vaccine platform technologies, such as mRNA and viral vectors, offer scalable solutions to vaccine manufacturing bottlenecks and can be rapidly adapted to emerging pathogens.

Equally vital is the integration of digital public health tools and citizen science. These approaches create space for creativity and shift the paradigm from passive information delivery to active public involvement. Citizens become agents of change, not just recipients of guidance from public health professionals and could actively contribute to fighting misinformation on social media.

Technological solutions, such as vaccine platform technologies or the recently announced AI-designed antibiotic targeting superbugs[6], offer hope. But technology alone is not sufficient. Tackling AMR requires an effective stewardship culture including responsible prescribing, public education, and regulation of antibiotic use in farming and agriculture, and which is reinforced through policy leadership and civic engagement. Any solution, whether data-driven, pharmaceutical, or digital, must be embedded within a framework of global cooperation and local accountability rooted in human commitment.