A major international study led by Chinese researchers has found that unchecked climate change could significantly worsen the global threat of antimicrobial resistance (AMR), potentially raising global AMR levels by more than 2% by 2050. The burden, the study warns will fall hardest on low- and middle-income countries already grappling with poor healthcare access and fragile infrastructure.
The research was conducted by a team from Peking University, using data from more than 32 million bacterial samples collected across 101 countries between 1999 and 2022. It focused on six priority drug-resistant pathogens, including carbapenem-resistant strains of E. coli, Klebsiella pneumoniae, and Acinetobacter baumannii bacteria known to cause deadly infections that are increasingly untreatable with existing antibiotics.
Climate and Pollution: New Drivers of Resistance
The study identified key environmental contributors to rising AMR levels. Air pollution (especially fine particulate matter), surface runoff from extreme rainfall, and temperature increases were all positively associated with resistance. Particularly, warmer temperatures were linked with spikes in carbapenem-resistant A. baumannii a growing threat in hospital settings.
These environmental trends suggest that the climate crisis could become a major accelerant of AMR spreading dangerous microbes faster and farther, even in areas with limited antibiotic use.
The Development Divide: Poorer Nations Pay the Price
Regions such as South Asia, sub-Saharan Africa, and the Middle East and North Africa are already experiencing higher average AMR prevalence. The study emphasized that low-income countries (LICs) and lower-middle-income countries (LMICs) face “unique challenges” such as poor sanitation, high antibiotic overuse, and unaffordable healthcare conditions that intensify the resistance crisis.
The model projects that if fossil fuel-intensive development continues, AMR prevalence could increase by:
- 0.9% in high-income countries
- 1.5% in upper-middle-income countries
- 4.1% in lower-middle-income countries
- 3.3% in low-income countries
Sustainable Development = Stronger Protection Against AMR
In an encouraging finding, the study’s projections show that sustainable development efforts could cut global AMR levels by 5.1% more than double the impact of simply halving global antibiotic use (2.1%).
The top four strategies that showed the most promise:
- Increased investment in public health systems
- Expanded immunization coverage
- Improved access to clean water, sanitation, and hygiene (WASH)
- Reduced out-of-pocket healthcare expenses (alone cutting AMR by 3.6%)
Beyond Antibiotics: A Multifaceted AMR Strategy Needed
While reducing antibiotic use remains crucial, the researchers stress that it is no longer sufficient as a standalone strategy. Climate conditions, health financing, and sanitation infrastructure now play an equally significant role.
They recommend aligning global AMR strategies with sustainable development goals something echoed in the 2024 UN General Assembly political declaration on AMR, which calls for:
- Basic WASH services in all healthcare facilities by 2030
- Universal vaccination programs
- Investments in climate-resilient, equitable health systems
The Road Ahead: Rising Temperatures, Rising Resistance
The researchers caution that even if sustainable goals are met, climate change may still increase AMR risks. Though the exact mechanisms remain unclear, extreme weather events, floods, and shifts in animal habitats may be increasing the spread of resistant bacteria and zoonotic diseases.
Antimicrobial resistance and climate change are converging crises. Without urgent, coordinated global action, both will continue to compound and destabilize health systems especially in the world’s most vulnerable regions.
The study closes with a clear call to action: nations must recognize the growing links between climate and AMR and act before the global health consequences become irreversible.