Abstract. Antimicrobial resistance (AMR) is a major global health threat, with the greatest burden falling on low- and middle-income countries (LMICs) also

Download the paper. The Consumer Goods Forum’s (CGF) Plastic Waste Coalition of Action has today released a paper showing how packaging design changes can improve recycling outcomes, reduce the amount of plastic waste that ends up in the environment and raise living standards for sector workers in low and middle-income countries (LMICs).

Cancer, particularly breast and cervical cancers, is a global health concern, mainly affecting Low- and Middle-Income Countries (LMICs). This highlights a rising burden on people, families, and healthcare systems. This scoping review aims to identify both the direct costs and the indirect costs associated with cervical and breast cancer treatment. Additionally, it seeks financial barriers and enablers to access breast and cervical cancer treatment in South Asia. Using the methodology developed by “Arksey and O'Malley” and “Levac et al.”, we searched multiple electronic databases to identify relevant records.

Why ACE frameworks need redesign for LMICs: (1) Standard tools miss systemic adversities—poverty, discrimination, unsafe environments—prevalent in rural India; (2) Dose–response rela…

Aluminum (Al) consumer cookware remains a cornerstone of global food preparation due to its exceptional thermal efficiency and low cost. However, in low- and middle-income countries (LMICs), the widespread reliance on low-purity, informally recycled artisanal alloys creates severe public health risks due to heavy metal migration into dietary pathways. This review explicitly links materials engineering for sustainable development with global safety frameworks by evaluating surface modification technologies designed to mitigate aluminum ion leaching under aggressive thermal and chemical cooking conditions. This review systematically synthesizes the thermodynamic, kinetic, and mechanical performance of three dominant protective systems: electrochemical anodization, sol-gel quasi-ceramic matrices, and fluoropolymer barriers. The chemical stability of these systems is analyzed using mass transport models, chelation-assisted coordination mechanics, and the Arrhenius activation energy framework. Furthermore, a sequential technical characterization workflow is established—linking Scanning Electron Microscopy (SEM-EDX), X-ray Photoelectron Spectroscopy (XPS), and Inductively Coupled Plasma Mass Spectrometry (ICP-MS)—to evaluate barrier performance against the strict specific migration limits (SML) enforced by the European Food Safety Authority (EFSA) and the United States Food and Drug Administration (FDA). While hard anodization and ceramic coatings offer excellent thermal stability, their long-term barrier performance is often compromised by interfacial shear stresses driven by mismatched coefficients of thermal expansion (CTE) and mechanical wear. This issue is particularly severe in informal metallurgical sectors. Artisanal castings feature high structural porosity and iron/copper micro-impurities that create localized galvanic micro-cells (Δ E > 1.0 V), accelerating the breakdown of surface oxide barriers and leading to heavy metal migration that routinely exceeds international safety standards by factors of 10 to 50. Critical commercial research gaps are identified, specifically the development of cost-effective, bio-based non-stick barriers (e.g., cross-linked green nanocomposites) and the implementation of decentralized circular economy scrap-sorting upgrades. Resolving these material vulnerabilities is essential for advancing UN Sustainable Development Goals related to good health and well-being (SDG 3), clean manufacturing (SDG 9), and responsible consumption and production (SDG 12). This work provides a clear roadmap for scalable, non-hazardous cookware manufacturing tailored for vulnerable populations.

Since the 1990s, fragility has been used to describe low- and middle-income countries (LMICs) with limited ability to respond to external threats in ways that ensure citizen safety, security, and wel...

AbstractAntimicrobial resistance (AMR) is a major global health threat, with the greatest burden falling on low- and middle-income countries (LMICs) also challenged with limited surveillance capacity. The UK Government's Fleming Fund was established in 2015 to strengthen AMR surveillance across Africa and Asia through a One Health approach. This paper draws on program experience, country implementation evidence, and published literature to describe how the Fleming Fund operationalized AMR surveillance, assess its contribution to the quantity and quality of surveillance data, identify key implementation challenges, and consider implications for future global surveillance strategies. The Fleming Fund combined investments in laboratory infrastructure, workforce development, quality assurance, data systems, governance, and data use. Across supported countries, these investments enabled substantial growth in routine bacteriology and antimicrobial susceptibility testing, strengthened reference and surveillance laboratory capacity, increased participation in external quality assessment, and expanded reporting to the World Health Organization's Global Antimicrobial Resistance and Use Surveillance System. The program also supported complementary surveillance approaches, including antimicrobial use and consumption data and, in some settings, burden-of-disease and genomic surveillance. Progress, however, has been uneven and remains vulnerable to fragile infrastructure, procurement and supply chain bottlenecks, workforce turnover, fragmented data systems, weak clinical–laboratory interfaces, limited representativeness, and uncertain long-term financing. The Fleming Fund experience shows that strengthening AMR surveillance in LMICs is feasible, but requires sustained, system-wide investment. Future strategies should prioritize integration with clinical care, stronger digital and analytical capacity, broader diagnostic access, and domestic financing to ensure that high-quality AMR data are generated, shared, and translated into action.

This paper builds on the other papers in this series to present high-level lessons learnt and considerations for the future of antimicrobial resistance (AMR) surveillance and its contribution to action on AMR in low- and middle-income countries.MethodsParticipatory synthesis involved engagement with individuals who had worked within and alongside the Fleming Fund from a range of organizations and geographies, to scope and solidify lessons learnt and future considerations relevant to a wide range of donors, partners, and policy makers or implementors. Contributors were invited to join a Writing Group, which included individuals from academia, clinical sciences, applied public, animal, environment, and food sciences health, as well as senior scientists and administrators from 14 organizations. The synthesis was informed by contributions to 4 virtual workshops and 3 drafts of the manuscript. Authors read and commented on the drafts, several wrote and referenced sections, and all gave substantive feedback with their reactions to the draft conclusions as consensus was built.ResultsOver nearly 10 years, the Fleming Fund achieved significant improvements in AMR surveillance. Analysis of the barriers and enablers across settings and systems highlights key lessons for how surveillance is positioned, funded, used, and innovated upon. The success of future AMR surveillance and its sustainability relies on planning within resource constraints for a sharpened system that focuses the scope, frequency, and depth of data to inform action, technical, and architectural developments directions to streamline investment and financing that supports country-led sustainable approaches.ConclusionsInvestment in AMR surveillance and broader AMR actions has yielded substantial progress. Expanded domestic public financing, large-scale private sector engagement, or enhanced multilateral support will be needed to ensure recent gains are sustained. Progress will require well-designed, targeted, and cost-effective investments to maintain current capacity while enabling further system strengthening.

Drawing on the Fleming Fund's work to strengthen antimicrobial resistance (AMR) surveillance across Africa and Asia during 2018–2026, this article provides one of the first syntheses of AMR surveillance data use in low- and middle-income countries.MethodsA participatory synthesis for narrative review was conducted to summarize experience across administrative levels (facility, subnational, national, and regional).ResultsData use was most evident at the facility level, in human health systems where resistance patterns, antimicrobial use, and clinical data increasingly informed antimicrobial stewardship, infection prevention and control, and other quality improvement initiatives. Data use in other sectors required different approaches. At the national level, Fleming Fund investments were associated with revisions of treatment guidelines, updates of essential medicines lists, and regulatory measures, primarily through improved governance and policy communities. Regional platforms supported member country data use at the national level. Subnational data use was undertaken in countries with decentralized health systems. Across levels, data use pathways driven by local priorities helped surveillance inform action.ConclusionsFleming Fund experience suggests that surveillance is more likely to inform action when data use is built into system design. Continued investment will be needed if AMR surveillance is to improve policy and practice in low- and middle-income countries.