AMR in a Changing Environment: Bridging Evidence, Policy, and Practice gaps at the Climate - AMR Nexus in Low- and Middle- Income countries
Sunday Ochonu Ochai
International Centre for Antimicrobial Resistance Solutions (ICARS),Copenhagen, Denmark
Climate change and antimicrobial resistance (AMR) represent two of the most consequential global health threats of our time, yet their intersection remains inadequately addressed across research, policy, and practice. The environmental dimensions of AMR (EDAR), encompassing the dissemination of drug-resistant bacteria, resistance genes (ARGs), and antimicrobial residues through soil, water, food systems, and the built environment, are amplified by climate-driven disruptions including rising temperatures, extreme weather events, and altered hydrological cycles. These dynamics are acutely felt in low- and middle-income countries (LMICs), which bear a disproportionate burden of AMR-attributable mortality and climate vulnerability despite contributing minimally to global greenhouse gas emissions.
Drawing on recent geospatial analyses mapping the convergence of climate stressors with AMR hotspots across food-producing animals in LMICs, and on ongoing intervention research across nine countries spanning aquaculture, livestock production, urban agriculture, and wastewater management, this presentation demonstrates the co-benefit of addressing both climate change and AMR in a single intervention, examines the evidence–policy–practice gaps that constrain effective action at the climate–AMR nexus. Key gaps include limited mechanistic and implementation evidence on climate–EDAR interactions in LMIC settings; the parallel and largely unintegrated operation of national AMR action plans and climate adaptation frameworks; AMS guidelines that inadequately address environmental and climate dimensions; and under-resourced pathways for South–South technology transfer and scale-up. Evidence from ICARS-supported projects across Africa and Asia demonstrates that context-appropriate, cost-effective integrated solutions are feasible and generate measurable co-benefits across AMR prevention, climate adaptation, and food security.
This presentation argues that addressing climate change and AMR as interconnected challenges demands coordinated, equity-centred action, placing LMIC communities at the heart of research agendas, financing decisions, and the co-production of solutions that are owned and sustained by those bearing the greatest burden of both crises.