Antimicrobial resistance in a one health and one world perspective—Mechanisms and solutions

We need a global and concerted action to combat the health threat of antimicrobial resistance (AMR). The World Health Organization (WHO) Global Action Plan on AMR aims at doing so in cooperation with the World Animal Health Organization (WOAH), the UN Food and Agriculture Organization (FAO), and the UN Environment Program (UNEP). However, after years of campaigning and worsened by the Covid-19 pandemic, resources for implementing national AMR action plans are still scarce in many regions of the world. AMR mitigation is largely a development issue, which recent UNEP guidance states also must consider environmental transmission pathways. Prevention of AMR at the point of use or release, sustainable and appropriate water, sanitation and hygiene (WASH), nutrition, and access to proper health care, are fundamental to preventing infections and reducing the spread of resistant infections. Further, antibiotics and biocides are often misused, and their wastes are poorly managed. All countries should restrict antibiotic use for healthy animals, reduce untreated antibiotic-laden discharges from the pharmaceutical industry, avoid unnecessary human use of antibiotics, and expand the use of existing vaccines and develop new to prevent and control AMR. The WHO Global Action Plan is a blueprint for all national action plans. However, we need stronger mechanisms and greater investment to turn the tide and start with the basics.