Introduction

The WHO Costing and Budgeting Tool for National Action Plans on Antimicrobial Resistance was developed to support countries in translating strategic plans into implementable, costed operational plans. Following the adoption of the Global Action Plan on AMR, countries were encouraged to develop National Action Plans (NAPs). While many countries successfully completed this process, a major challenge remained: understanding how much implementation would actually cost and how to finance it sustainably.

Only a limited number of NAPs were fully funded at the time of their development, highlighting a critical gap between political commitment and financial readiness. Countries lacked a structured, comparable methodology to estimate resource needs, communicate them to finance ministries, or engage international donors and development partners effectively.

In response to this gap, WHO — together with global partners and country stakeholders — developed this tool through an extensive consultation and piloting process across multiple countries and regions. The result is a practical and standardized approach to costing that can be applied across diverse country contexts, health systems, and levels of NAP maturity.

About the Tool

The WHO AMR Costing and Budgeting Tool is a flexible, Excel-based instrument designed to support countries in estimating the full cost of AMR NAP activities using a structured, bottom-up approach. Rather than applying broad averages or regional estimates, the tool asks users to define specific activities, identify the inputs required to carry them out, and assign costs based on local unit prices and quantities.

This approach ensures that cost estimates reflect each country’s specific operational context, including its existing health system infrastructure, workforce capacity, and financing landscape. The tool is structured to accommodate activities across all five strategic objectives of the Global Action Plan — awareness, surveillance, infection prevention, stewardship, and research and innovation — as well as sector-specific priorities under a One Health framework.

Its modular design allows different sectors or ministries — including human health, animal health, agriculture, and environment — to contribute their estimates separately, which can then be consolidated into a single national costed plan. This structure supports interministerial coordination and ensures that no sector’s priorities are overlooked in the final financing picture.

How the Tool Supports Countries

Beyond estimating costs, the tool is designed to serve as a bridge between technical planning and financial decision-making. It helps countries move from high-level strategic commitments to concrete, implementable plans with clear resource requirements attached to each activity.

This is particularly valuable when engaging ministries of finance, which often require structured, evidence-based budget proposals before committing resources to health programmes. The tool produces outputs that are directly usable in national budget cycles and development partner discussions, reducing the technical burden on country teams while increasing the credibility of their financing requests.

For countries seeking external support, the tool also enables the construction of investment cases — demonstrating to donors and international financing mechanisms both the scale of the AMR challenge and the specific cost of addressing it. Countries that have piloted the tool have used its outputs to engage global health funds, bilateral donors, and regional development banks as part of their AMR financing strategies.

Over time, the tool can also support monitoring and accountability by providing a baseline cost estimate against which actual expenditure can be tracked, helping countries identify where implementation is on track and where additional support or reprioritisation may be needed.