Antimicrobial resistance in a changing climate: a One Health approach for adaptation and mitigation

Background Antimicrobial resistance (AMR) and climate change are interconnected global challenges that threaten human, animal, and environmental health. The World Health Organization has identified AMR as a major public health crisis, further intensified by climate-induced disruptions such as rising temperatures, altered precipitation patterns, and extreme weather events. These environmental changes accelerate the spread and persistence of resistant pathogens across diverse ecosystems, complicating AMR containment efforts. Main body This study explores the complex interplay between climate change and AMR, analyzing key drivers such as environmental contamination, intensive agricultural practices, urbanization, and population displacement. Climate variability enhances microbial adaptation, increases resistance gene transfer, and expands AMR hotspots in aquatic, terrestrial, and healthcare environments. Low- and middle-income countries are disproportionately affected due to inadequate infrastructure, limited healthcare access, and increased exposure to resistant pathogens. Effective mitigation and adaptation strategies include strengthening AMR surveillance, promoting sustainable farming practices, integrating climate-resilient healthcare systems, and aligning global policies under the One Health framework. Emerging technological solutions—including climate-resilient antibiotics, artificial intelligence-driven AMR prediction models, and advanced wastewater treatment technologies—offer promising pathways for intervention. Case studies from flood-prone regions, aquaculture industries, and climate-adaptive healthcare models illustrate successful AMR containment strategies. Short conclusion Addressing AMR in the context of climate change requires interdisciplinary collaboration across scientific research, policy development, and technological innovation. A comprehensive and integrated approach, emphasizing global health strategies, sustainable resource management, and community engagement, is essential to mitigating AMR and advancing the United Nations Sustainable Development Goals.