One Health Antimicrobial Resistance Research Network

Escalating Global Threat

Antimicrobial resistance (AMR) has intensified in recent years, with fresh data underscoring its acceleration. The World Health Organization's 2025 Global Antibiotic Resistance Surveillance Report, drawing on over 23 million confirmed cases from more than 100 countries, showed that resistance to key antibiotics increased markedly between 2018 and 2023. In many regions, common pathogens like Escherichia coli and Klebsiella pneumoniae now resist first-line treatments at rates exceeding 40-70% for critical drug classes such as third-generation cephalosporins and fluoroquinolones.

This surge stems from overuse in medicine, agriculture, and veterinary practice, compounded by inadequate sanitation and environmental contamination. The interconnected nature of resistance—bacteria moving between humans, livestock, and ecosystems—demands a One Health response that integrates these sectors rather than treating them separately.

Real-world consequences are already severe. In 2021, AMR directly caused 1.14 million deaths and contributed to nearly 5 million more. Projections indicate 39 million deaths attributable to AMR between 2025 and 2050 if trends continue. Healthcare systems face mounting pressure: treating resistant infections costs billions annually, with global estimates around $66 billion today and potentially $159 billion by 2050. Broader economic fallout includes trillions in lost GDP from reduced productivity and prolonged illnesses.

Low- and middle-income countries bear the heaviest burden, where resistance levels are highest and surveillance weakest, exacerbating inequalities in access to effective treatments. Even in high-income settings, outbreaks of resistant strains, such as carbapenem-resistant Enterobacterales surging in some regions, complicate routine procedures like surgery or chemotherapy.

Non-obvious tensions include the trade-offs in agriculture: reducing antibiotic use in livestock to curb resistance risks food production shortfalls or higher costs, while pharmaceutical innovation lags due to poor returns on new antibiotics. Environmental reservoirs, such as hospital effluents and polluted waterways, create hidden pathways for resistance genes to spread undetected. Recent initiatives like the European Union's 2025-launched Partnership on One Health Antimicrobial Resistance, backed by €253 million over ten years, aim to bridge these gaps through collaborative research, data sharing, and policy alignment across 30 countries.

Deadlines loom large: without scaled interventions, resistance could undermine modern medicine's foundations, rendering common infections deadly once more and jeopardizing global health security amid other pressures like climate change and emerging pathogens.