Justice at the intersection of climate change and anti-microbial resistance

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This paper examines the intersection between the growing global threats of antimicrobial resistance (AMR) and climate change through a justice lens, considering to what extent the two issues have been or should be integrated in policy and research, through on an exploration and analysis of peer-reviewed literature and public sector reports.

Climate change has been described as a “threat multiplier” for infectious diseases (WHO, 2017), through multiple factors including spread of disease vectors, sharing of scarce water resources, increased exposure through flooding, and climate migration issues. Treatments are becoming less effective as pathogens develop resistance to antimicrobial drugs. Over-use of antimicrobials in human and veterinary care, drives AMR in people, in their food chains, and in the environment, in particular in countries which lack regulatory oversight and controls on antimicrobial prescribing and poor sanitation, which are often also those most at risk from climate change. The highest environmental concentrations of common antibiotics are A global study detected residues of common antibiotics in 65% of investigated environments, with the highest concentrations found in Bangladesh, Kenya, Ghana, Pakistan and Nigeria (Wilkinson et al., in press). Drug manufacturing plants contribute too, particularly in countries where environmental regulation is lax (Larsson et al., 2014). Vulnerable people, in particular those in developing countries who lack access to primary and secondary healthcare, are likely to be most at risk from combined impacts.

Comparisons of scale and urgency between both global challenges have been made (e.g. Woolhouse et al., 2015), but their interconnectedness, which is woven into a complex web of anthropogenic environmental change, has received little attention to date and it is unclear whether impact projections have taken due account of compounding effects. A global governance framework for AMR, still in its infancy, takes cognisance of SDGs but does not frame AMR as a justice issue.
Original languageEnglish
Publication statusUnpublished - 21 Jun 2019


  • anti-microbial resistance
  • climate change


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