Economic benefits of AMR surveillance in Papua New Guinea

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Fleming Fund poses potential healthcare cost savings of over £5M

Image shows: Central Public Health Laboratory, AMR National Reference Laboratory - supported by the Fleming Fund (credit: Burnet Institute).

Before the Fleming Fund investment, Papua New Guinea had limited capacity for surveillance of antimicrobial resistance (AMR). Laboratory systems were fragmented, with inconsistent diagnostic capacity, a lack of standardised protocols, and minimal data sharing between hospitals and national health authorities.

Most of the country’s AMR data was obtained from isolated research studies rather than routine surveillance, making it difficult for policymakers to understand the true scale of resistance or to respond effectively. There was also little awareness of AMR’s economic impact, and resource allocation for laboratory strengthening was inadequate.

The Burnet Institute leads the Fleming Fund Country Grant (FFCG) in Papua New Guinea, in close collaboration with PNG stakeholders and government partners. The grant has strengthened surveillance systems to tackle AMR, supporting nine surveillance sites across human, animal, and environmental health, including a National Reference Laboratory in the country’s capital, Port Moresby. It has also supported the development of the AMR workforce and governance structure.

We spoke to the Burnet team about the economic impact of AMR surveillance and the potential cost savings of over £5M for the human health sector.

The FFCG team first initiated economic studies to build the case for sustained investment in AMR surveillance. The team analysed hospital surveillance data (from three Fleming Fund-supported sites) to quantify the direct and indirect costs of drug-resistant infections, as well as the potential savings from improved detection and stewardship.

The results of the preliminary analysis were first presented to stakeholders in March 2025, including senior management and key officials from all government authorities involved in AMR surveillance in both human health and animal health sectors.

Return on investment

The findings demonstrated the significant economic impact that AMR has on the PNG health system and economy more broadly. “This robust evidence has strengthened our ability to communicate with the government and stakeholders, highlighting not only the health benefits, but also the strong economic rationale for continuing AMR surveillance once Fleming Fund support ends,” noted Prof Robert Power, Project Director of the FFCG at the Burnet Institute.

The analysis showed that if the government invested approximately £63,000 annually in AMR surveillance at three surveillance sites, it could generate yearly savings of around £121,000. “For every £1 invested, there is a return of approx. £1.92 in direct savings ─ mainly, through reduced treatment costs, shorter hospital stays, and less productivity loss,” said Possawat Jorkate, Technical Co-ordinator, FFCG at the Burnet Institute.

63K

AMR surveillance investment

121K

results in annual savings

£1.21

savings for every £1 invested

Healthcare cost savings

With data derived from three regional surveillance sites in Papua New Guinea, the primary challenge was ensuring data quality and completeness, particularly at remote sites. When estimating economic impacts, where PNG-specific data were lacking, the team relied on reduction rates and costing data from other low- and middle-income countries, adapting them to the PNG context.

“Despite these limitations, the findings were compelling: for example, effective surveillance with AMS intervention could reduce drug-resistant typhoid cases by 50% within three years, potentially saving over £5 million in treatment costs, extended hospital care, and lost productivity”, said Prof Power. “These savings would allow the government to redirect limited resources to other urgent health needs, while families and communities would be shielded from the broader social and economic impacts of AMR.”

Shared AMR goals

The collaboration between clinical, laboratory, and policy teams worked particularly well, with strong government engagement that ensured results were aligned with national priorities. This involved shared goals and regular Technical Working Groups, which helped standardise protocols and improve the data quality.

The animal health sector was also engaged through the One Health approach, with participation from NAQIA and veterinary services in planning surveillance and providing training.

“While laboratory capacity remains limited in animal health, we were able to establish sentinel surveillance and begin collecting baseline AMR data from livestock. The findings revealed resistance patterns in key zoonotic pathogens, underscoring the need for integrated surveillance and stewardship in both human and animal sectors,” said Paula Pupune, One Health Thematic Lead, FFCG at the Burnet Institute.

AMR advocacy tools

The economic studies are already playing a key role in advocacy with Papua New Guinea government stakeholders. The findings have supported the proposal for the government to sustain investment in AMR surveillance. They have featured in stakeholder briefings, national planning discussions, and efforts to integrate AMR surveillance into routine health budgets.

They have also been submitted as an abstract to the One Health-themed PNG Medical Symposium 2025, to be held in Port Moresby, early September.

As a next step, the FFCG has provided technical support and developed a Burden of Disease protocol for AMR, with pilot data collection underway at the supported surveillance site, Goroka Provincial Hospital. “Once data collection is completed in mid-2026, Papua New Guinea will have accurate local information to strengthen the next version of the economic case for AMR, further guiding national investment and action beyond the Fleming Fund,” said Possawat.

The team has also developed an economic analysis calculator tool, which has been shared with the Fleming Fund Regional Grant, Technical Assistance for Data Evidence and Use Asia, and with the Papua New Guinea government to update cost estimates as more in-country specific data becomes available.

“We are continuing to strengthen local capacity for economic and epidemiological analysis to ensure momentum is sustained beyond the Fleming Fund support,” said Prof Power.