Assessing antimicrobial resistance connectivity across One Health sectors

Antimicrobial resistance (AMR) has evolved through a continuous arms race since the first use of antimicrobial agents. Although resistance genes are ancient and widespread in nature, decades of antimicrobial use have accelerated their emergence and transmission across humans, animals, and the environment. The widespread use of antimicrobials and environmental pollution have amplified this cross-sector dissemination. While most countries have developed AMR National Action Plans, implementation remains limited, especially in low- and middle-income regions, due to the difficulty of tracking and managing AMR connectivity. This paper reviews the evolution and current state of AMR, highlighting the ecological, microbial, and genetic links that drive its spread. It proposes using genomics and metagenomics to study these connections and calls for harmonized, cross-sector research to better understand and control AMR dissemination globally.