The WHO costing and budgeting tool for national action plans on antimicrobial resistance-a review and assessment of impact in Africa.

Background: Antimicrobial resistance (AMR) is a global public health crisis affecting human health, animal health, plant health, and the environment. In 2015, all WHO Member States endorsed the Global Action Plan on AMR and committed to develop multi-sectoral national action plans (NAPs) under a 'One Health' approach. To accelerate the implementation of AMR NAPs, the WHO introduced a costing and budgeting tool in 2021 to support prioritization of interventions, identification of activities financed through existing budgets, estimation of implementation costs and assessment of funding gaps. Objectives: To assess the impacts resulting from the use of the costing and budgeting tool at national level in WHO African region (AFRO) Member States. Methods: National AMR focal points from the human, animal, agriculture and environmental sectors in 15 WHO African Region Member States trained on the tool completed a questionnaire using Google Forms via a secure web-based survey link. Results: Eleven countries reported mobilizing funding using costed data generated through the tool. Costed NAPs informed policy decisions in seven countries and improved stakeholder collaboration in funding efforts. However, the use of the tool revealed significant challenges, including insufficient domestic financing and lack of congruence of donor priorities with national needs. Conclusions: Costing One Health AMR NAPs serves as an important catalyst for realistic budgeting and resource planning including resource mobilization to ensure both effective implementation and the long-term sustainability of AMR interventions.