Environment and AMR

Antimicrobial resistance (AMR) poses a significant global health threat, with the environment playing a vital yet often underestimated role in its development and dissemination. In addition to the misuse of antibiotics in humans and animals, environmental routes—such as soil, water, air, and waste—act as reservoirs and transmission pathways for resistant bacteria and resistance genes. Sources like untreated sewage, hospital effluents, pharmaceutical waste, agricultural runoff, and livestock practices significantly contribute to environmental contamination, fostering resistance hotspots. Sub-inhibitory levels of antibiotics in soil and water apply selective pressure, while mobile genetic elements support horizontal gene transfer among microbes. People face exposure through contaminated water, food products, direct contact, or inhaling bioaerosols, which increases serious health risks for both humans and animals. Despite limited surveillance and monitoring of environmental AMR, these efforts are crucial within the One Health framework. Global and national strategies, including initiatives by UNEP and WHO, expose regulatory gaps, especially in wastewater treatment and pharmaceutical waste control. Effective mitigation requires improved wastewater treatment, proper waste disposal, responsible antibiotic use, collaboration between the public and private sectors, and heightened public awareness. Recognising the environment as a key factor in AMR is essential for sustainable management and for preserving the efficacy of antimicrobials for future generations.