The study focuses on the environmental dimensions of AMR, which occurs when bacteria, viruses, fungi, and parasites change over time and no longer respond to medicines.

It calls for strengthening action to reduce the emergence, transmission and spread of “superbugs” - strains of bacteria that have become resistant to every known biotic – and other instances of AMR, which are already taking a serious toll on human, animal, and plant health.

Another example of inequality

“The environmental crisis of our time is also one of human rights and geopolitics – the antimicrobial resistance report published by UNEP today is yet another example of inequity, in that the AMR crisis is disproportionately affecting countries in the Global South,” said Prime Minister Mia Mottley of Barbados, who chairs a UN-backed initiative of world leaders and experts examining the issue.

AMR is among the top 10 global threats to health, according to the World Health Organization (WHO).

In 2019, an estimated 1.27 million deaths globally were directly attributed to drug-resistant infections.  Overall, nearly five million deaths were associated with bacterial AMR.

It is expected that some 10 million additional direct deaths annually by 2050 will occur, which is equal to the number of deaths caused globally by cancer in 2020.

Food and health at risk

AMR also affects the economy and is expected to cause a drop in Gross Domestic Product (GDP) of at least $3.4 trillion annually by the end of the decade, pushing some 24 million people into extreme poverty.

The pharmaceutical, agricultural and healthcare sectors are key drivers of AMR development and spread in the environment, together with pollutants from poor sanitation, sewage and municipal waste systems.

Inger Andersen, the UNEP Executive Director, explained that the triple planetary crisis - climate change, pollution and biodiversity loss – have contributed to this.

“Pollution of air, soil, and waterways undermines the human right to a clean and healthy environment. The same drivers that cause environment degradation are worsening the antimicrobial resistance problem. The impacts of anti-microbial resistance could destroy our health and food systems,” she warned.

One Health response

Tackling AMR requires a multisectoral response that recognizes that the health of people, animals, plants and the environment are closely linked and interdependent.

This is in line with the One Health framework developed by UNEP, WHO the UN Food and Agriculture Organization (FAO), and the World Organisation for Animal Health (WOAH).

The report was launched at the Sixth Meeting of the Global Leaders Group on AMR, chaired by Prime Minister Mottley.

It contains measures to address both the decline of the natural environment and the rise of AMR, with focus on addressing key pollution sources from poor sanitation, sewage, and community and municipal wastes.

Recommendations include creating robust governance, planning, regulatory and legal frameworks at the national level, and increasing global efforts to improve integrated water management.

Other measures suggested are establishing international standards for what constitutes a good microbiological indicator of AMR from environmental samples, and exploring options to redirect investments, including to guarantee sustainable funding.