Managing Environmental Antimicrobial Resistance Under Climate Change
Arnab Majumdar, Imperial College London; David R. Johnson, Swiss Federal Institute of Aquatic Science and Technology and University of Bern; and Debojyoti Moulick, University of Kalyani
Republished with permission from Integrated Environmental Assessment and Management (IEAM), Volume 22, Issue 2, March 2026, with minor edits for style.
The escalating convergence of climate change and antimicrobial resistance (AMR) represents one of the most pressing yet inadequately addressed environmental health challenges of our time. Climate-induced environmental alterations, including rising global temperatures, extreme weather events and shifts in precipitation patterns, are fundamentally accelerating the development and dissemination of AMR through multiple interconnected pathways (van Bavel et al., 2024). Rising temperatures facilitate bacterial adaptation and enhance the efficiency of horizontal gene transfer, while extreme flooding and drought events disrupt sanitation infrastructure and promote the mixing of resistant bacteria across environmental compartments. Furthermore, climate-induced ecosystem disruptions alter microbial community dynamics and increase exposure to heavy metals and pollutants that co-select for antibiotic resistance genes (ARG) through mechanisms involving mobile genetic elements on plasmids, transposons and integrons (Gillieatt and Coleman, 2024).
Despite growing recognition of these intersecting threats, critical knowledge gaps persist that fundamentally hinder evidence-based policy development and effective intervention strategies. Perhaps most concerning is the absence of quantitative relationships between specific environmental factors and AMR development (Bengtsson-Palme et al., 2023). Current surveillance systems remain fragmented, with insufficient monitoring data from environmental matrices such as soil, water and air. The lack of standardized methodologies for environmental AMR monitoring across different countries and regions creates substantial barriers to producing internationally comparable datasets, while low- and middle-income countries face particularly acute challenges due to weak laboratory infrastructure, limited technical capacity, inadequate funding and poor health information systems (Peters et al., 2024). Moreover, comprehensive government policies specifically addressing climate–AMR interactions remain largely absent, with most countries lacking integrated frameworks that connect climate adaptation strategies with AMR mitigation efforts under the One Health approach (Alhassan and Ahmad, 2025).
To address these multifaceted challenges, a comprehensive suite of mitigation strategies must be urgently implemented across multiple scales and sectors. At the technical level, wastewater treatment infrastructure requires substantial enhancement, with evidence demonstrating that modified anaerobic–aerobic processes achieve ARG removal efficiencies exceeding 90 percent, though implementation faces significant financial and technical barriers, particularly in resource-limited settings. Standardized environmental AMR surveillance protocols must be established globally, building upon frameworks such as the WHO Global Antimicrobial Resistance and Use Surveillance System (GLASS) and the emerging European Environmental AMR Surveillance Network (EARS-Env). Nature-based solutions, including constructed wetlands, biofilm channels and phytoremediation systems, offer promising complementary approaches that simultaneously address wastewater treatment, AMR mitigation and climate resilience while providing ecosystem co-benefits (Lewycka et al. 2025).
At the policy and governance level, integrated frameworks connecting climate adaptation and AMR mitigation under the One Health paradigm are essential. The Quadripartite collaboration (Food and Agriculture Organization, United Nations Environment Programme, World Health Organization and World Organization for Animal Health) provides a crucial foundation for coordinated cross-sectoral strategies (FAO et al. 2022), yet national and regional implementation remains inconsistent. The U.K.’s 2024–2029 National Action Plan exemplifies comprehensive approaches emphasizing improved waste management, strengthened surveillance, antimicrobial stewardship and explicit recognition of climate–AMR linkages, though similar frameworks are urgently needed globally.
Investment in research infrastructure and capacity building, particularly in resource-limited settings, represents a critical enabling factor for long-term progress. Addressing the climate–AMR nexus requires sustained funding commitments, multisectoral partnerships and political will to translate scientific evidence into coordinated global action. As the Global Leaders Group on AMR has emphasized, the interconnections between AMR and climate change demand urgent attention and integrated solutions that recognize both of these global problems share common drivers and require coordinated responses. Without immediate and comprehensive action spanning technical innovation, surveillance enhancement, policy integration and international cooperation, the dual threats of climate change and AMR will continue to amplify one another, with devastating consequences for global health security, food systems and sustainable development.
For the complete list of references, see the original article in IEAM at https://doi.org/10.1093/inteam/vjae018.
Contact: Debojyoti Moulick