Managing environmental antimicrobial resistance (AMR) under climate change: current gaps and future needs 

Climate change is increasingly recognized as an important driver of antimicrobial resistance (AMR) in the environment. Rising temperatures can accelerate bacterial mutation and enhance the stability and transfer of resistance genes, while extreme weather events such as floods and droughts disrupt sanitation systems and promote the spread and mixing of resistant microbes. Changes in precipitation, ecosystem disturbance, and exposure to pollutants and heavy metals can further reshape microbial communities and co-select for antibiotic resistance. Although strategies such as improved waste management, wastewater treatment, and antibiotic stewardship are being promoted—for example in the UK’s 2024–2029 National Action Plan—major challenges remain. Significant knowledge gaps persist regarding how environmental factors quantitatively influence AMR, environmental surveillance is still limited (especially in low- and middle-income countries), and most national policies do not yet integrate climate adaptation with AMR mitigation. Addressing the climate–AMR nexus will therefore require stronger surveillance, standardized monitoring methods, and coordinated One Health policies that connect environmental, human, and animal health.