Antimicrobial stewardship from a One Health perspective

The article highlights antimicrobial resistance (AMR) as a major global threat driven by the misuse and overuse of antimicrobials. It identifies antimicrobial stewardship (AMS) as a central, multisectoral strategy to curb AMR within a One Health framework. The review examines clinical, economic, sociocultural, and environmental factors shaping antimicrobial use, noting differences between high- and low-income settings and stressing context-specific barriers. It emphasizes the role of governance, financing, surveillance, digital tools, and behavioural science in building sustainable AMS programmes. Key components include policy integration, monitoring appropriateness, and equity-focused interventions that address structural barriers and improve access to quality antimicrobials. The authors call for aligning political commitment, funding, and innovation to scale AMS, protect antimicrobial efficacy, and strengthen global health security.