CABI has joined a team of international scientists who argue that antimicrobial resistance (AMR) is a complex problem that requires broad One Health stewardship from local to global levels across the antimicrobial lifecycle.
AMR occurs when microorganisms such as bacteria, viruses, fungi, and parasites evolve to resist the effects of medications, making infections harder or impossible to treat.
Recognized by the WHO as one of the top global public health and development threats, AMR jeopardizes the effectiveness of modern medicine and increases the risk of disease spread, severe illness, and death.
AMR is a One Health challenge, affecting human, animal and plant health and the environment. In September 2024, the United Nations General Assembly (UNGA) reinforced AMR as a global public health priority – urging governments to prevent, contain and mitigate its spread and this One Health agenda will be continued into 2026 when France takes the G7 presidency promoting OH at all levels.
In 2021, resistant bacterial infections were linked to an estimated 4.71 million deaths worldwide – with the highest mortality rates in sub-Saharan Africa and South Asia – and the number of fungal diseases is estimated to have doubled in the last decade to 3.8 million with management compromised by rising antifungal resistance.
Predictive models using recent data on production and disease inputs indicate that antimicrobial use (AMU) and the associated AMR-disease burden is estimated to cause a cumulative GDP loss of US $575 to US $953 billion by 2050 escalating to US $1.1 to US $5.2 trillion.
Stewardship needed in six stages of antimicrobial lifecycle globally
The scientists, whose study is published in the journal Communications Medicine, say curbing AMR is a One Health priority and stewardship is needed in six stages of the antimicrobial lifecycle.
These six stages include research and development, production, registration evaluation and market authorization, selection, procurement and supply, appropriate and prudent use and disposal.
They are outlined by the World Health Organization (WHO), the Food and Agriculture Organization of the United Nations (FAO), and the World Organization for Animal Health (WOAH).
The scientists believe that end-to-end stewardship will individually and collectively help to maintain the efficacy of existing and new antimicrobials for the optimal management and prevention of infections in humans, animals, and plants while protecting the environment.
Safeguard global health, food security, and ecosystems
Dr Phil Taylor, a co-author of the paper from CABI, said, “This Perspective proposes a comprehensive One Health stewardship framework that spans the entire antimicrobial lifecycle – from innovation to disposal – across human, animal, plant, and environmental sectors.
“By embedding stewardship principles at all levels, the framework aims to preserve antimicrobial efficacy, mitigate resistance, and safeguard global health, food security, and ecosystems.”
Stewardship should be central to all actions taken by global stakeholders
The scientists stress that stewardship should be central to all actions taken by global stakeholders, national governments, and organizations as they work to increase investment and implement new policies in line with the 2024 UNGA Political Declaration of the High-Level Meeting on AMR.
Achieving the commitments set out in the Declaration, they say, requires coordinated efforts from every sector and collective action across all stakeholder communities, including policymakers and the public.
Dr Taylor added, “A holistic, One Health, whole-of-society approach is essential, breaking away from traditional siloed efforts and embracing interconnected strategies. Collaboration, cooperation, consultation, communication, education, and capacity-building must form the foundation of all stewardship initiatives.
“These principles ensure that each sector contributes to a unified strategy, sharing knowledge and resources to effectively mitigate AMR.”
Their research is the outcome of a collaborative process between members of the Multi-Stakeholder Partnership Platform Action Group on Stewardship Across the Antimicrobial Lifecycle: A One Health Approach.
It received funding from the One Health Hub – a knowledge, evidence, and learning platform that promotes a cross-sectoral One Health agenda encompassing human, animal, plant, and ecosystem health.
Additional information
Main image: There is the necessity to embrace a one health approach that recognizes AMU in plant health. (Credit: Phil Taylor CABI).
Full paper reference
Altevogt, B.M., Taylor, P., Akwar, H.T. et al. A One Health framework for global and local stewardship across the antimicrobial lifecycle. Commun Med 5, 414 (2025). https://doi.org/10.1038/s43856-025-01090-4
The paper can be read open access here.
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