Antimicrobial resistance (AMR) is not a distant threat – it is happening now. Despite years of warnings, antibiotics continue to be overused and misused, contributing to a crisis responsible for 1.27 million deaths annually and linked to nearly 5 million more (Murray et al., 2022). If left unchecked, AMR could kill 10 million people per year by 2050 (O’Neill, 2016).

While policymakers recognise AMR as a serious issue, responses remain slow and uncoordinated. The key drivers – antibiotic overuse in human medicine, agriculture, and environmental pollution – are well-documented (Salam et al., 2023). Yet, weak regulations, economic pressures, and a lack of collaboration hinder progress. The One Health approach, which connects human, animal, and environmental health, offers a promising solution – but is it being implemented effectively?

Human Health: Are Stewardship Programs Enough?

Antimicrobial stewardship programs to control antibiotic use in hospitals and clinics have been beneficial (Salam et al., 2023), but they are mostly found in wealthier countries with strong healthcare systems. Meanwhile, global antibiotic use increased by 46% between 2000 and 2018, with a staggering 76% rise in low- and middle-income countries (Browne et al., 2021). Many of these countries lack access to proper diagnostics, leading to overprescription. Even in wealthier nations, unnecessary antibiotic use remains common, as short-term convenience often prioritizes long-term health.

Agriculture: Public Health vs. Economic Interests

The use of antibiotics in farming is a major contributor to AMR. Although the European Union banned antibiotic growth promoters in 2006, many countries continue their use, prioritising livestock productivity over public health (Van Boeckel et al., 2017). The Netherlands successfully reduced antibiotic use in animals by 56% between 2007 and 2012 through strict regulations and collaboration with farmers (Speksnijder et al., 2015). However, many nations resist similar measures due to economic concerns. Without enforceable global agreements, efforts to reduce antibiotic use in agriculture will remain inconsistent. 

Environmental Contamination: The Overlooked Risk

The environmental dimension of AMR is often ignored. Wastewater from hospitals, farms, and pharmaceutical factories creates reservoirs of resistant bacteria that spread resistance genes through ecosystems (Krzemiński et al., 2020). Despite clear evidence, regulations to control this pollution remain weak. Addressing this issue requires stricter waste management policies and investment in better filtration technology to prevent antibiotics from contaminating the environment.

From Awareness to Action: The Time Is Now

The WHO’s Global Action Plan on AMR outlines five key objectives: raising awareness, improving surveillance, preventing infections, optimizing antibiotic use, and investing in research (World Health Organization, 2015). However, these efforts largely depend on voluntary national actions, leading to inconsistent results. A legally binding, globally coordinated strategy is needed to drive real progress.

While One Health is a powerful concept, its implementation is hindered by bureaucratic silos and conflicting priorities. Effective action requires stronger political commitment, better cross-sector collaboration, and clear accountability. Without these, One Health risks becoming another well-intentioned but underutilized strategy.

AMR is already reshaping medicine, food production, and the environment. Without urgent action, common infections could become deadly, surgeries too risky, and food supplies unstable. This is not just a medical crisis – it is a failure of global governance.

The question is not whether we need One Health – we do – but whether we are willing to act decisively. The world must choose between series, coordinated efforts or a future where antibiotics become ineffective. The time for hesitation is over. 

 Reference 

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