Beyond breakpoint – reconceptualising AMR as a symptom of planetary stress

Planetary boundaries, which define the safe space for humanity, are often overlooked in assessing the impacts of planetary stress on microbes. Microbes represent the majority of phylogenetic diversity on Earth and underpin multiple planetary systems. The Stockholm Resilience Centre reported that six of nine planetary boundaries were breached in 2024, affecting the stability of the Earth as a system. The neglect of microbial health within the environment, including antimicrobial resistance (AMR), is not unique to current planetary boundary reports. AMR is a natural microbial response to selective pressure of natural and synthetic molecules, and has been primarily understood from an anthropocentric perspective. The dominant clinical approach to antimicrobial stewardship has focused on stabilizing sensitivity in relation to individual bug-drug combinations, neglecting the wider microbiota impacts of expanding antimicrobial infrastructures in food and health systems. Advances in genomics have allowed researchers to model the global dispersion of AMR genes and track the accelerating historical abundance of these genes.