There is growing evidence that the environment plays a key role in the development, transmission and spread of AMR. Its proliferation is linked to the triple planetary crisis of climate change, nature and biodiversity loss, pollution and waste.

AMR is a complex problem that requires both sector-specific actions in the human health, food production, animal and environmental sectors, and a coordinated approach across these sectors.

The old saying, “An ounce of prevention is worth a pound of cure” applies to AMR. Preventative measures, such as improving water, sanitation and hygiene, as well as putting in place strong international and national regulatory frameworks to enforce controls on the sale and distribution of antibiotics, will go a long way in reducing AMR.

Antimicrobial resistance has been identified in all regions of the world and can rapidly spread. The amount of resistance and number of infections is different worldwide, along with the use of antibiotics and antifungals, access to clean water and adequate sanitation, vaccination coverage, and access to quality healthcare.

Wastewater treatment plants (WWTPs) reduce contaminants in wastewater before discharging the treated water into waterways. However, some antibiotic and antifungal residues and resistant germs and genes can survive treatment because wastewater treatment systems are not specifically designed to kill or remove them.

Some bacteria are naturally resistant to certain antibiotics (intrinsic or inherent resistance). A more worrying problem is when some bacteria, that are normally susceptible to antibiotics, become resistant as a result of genetic changes (acquired resistance).