That is the central message from Aitziber Echeverria, AMR Coordinator, Chemicals and Health Branch at the United Nations Environment Programme (UNEP), who argues that environmental action is no longer an optional component of the fight against AMR but a prerequisite for its success.
Her warning comes as global efforts increasingly recognise that AMR is not confined to hospitals, farms or healthcare facilities. Drug-resistant microorganisms, antimicrobial residues and resistance genes can enter and circulate through the environment, making pollution control and environmental management essential to containing the threat.
"The environment plays a key role in the emergence, transmission and spread of AMR, as per the UNEP report Bracing for Superbugs. The environment and AMR cannot be treated separately. That is the One Health concept,” she said while speaking at the 6th Annual Global Media Forum on AMR ahead of World AMR Awareness Week (WAAW 2026: November 18-24).
"AMR is often discussed as a public health and agriculture challenge — which of course it is, and a major one — but it is an environmental issue too," Echeverria said.
Her warning comes as global efforts increasingly recognise that AMR is not confined to hospitals, farms or healthcare facilities. Drug-resistant microorganisms, antimicrobial residues and resistance genes can enter and circulate through the environment, making pollution control and environmental management essential to containing the threat.
"The environment plays a key role in the emergence, transmission and spread of AMR, as per the UNEP report Bracing for Superbugs. The environment and AMR cannot be treated separately. That is the One Health concept,” she said while speaking at the 6th Annual Global Media Forum on AMR ahead of World AMR Awareness Week (WAAW 2026: November 18-24).
From recognition to implementation
For Echeverria, the global conversation has reached a decisive turning point: the environmental dimensions of AMR are increasingly acknowledged, but recognition must now translate into implementation.
"We are moving now from recognising the environmental dimensions of AMR to systematically addressing them. We now need implementation,” she said.
The 2024 UN General Assembly Political Declaration on AMR reinforced the need for coordinated action across sectors. Echeverria stressed that environmental considerations must be embedded in this response rather than treated as an afterthought. "As stated in the 2024 UN General Assembly Political Declaration, to tackle AMR we need to combine multi-sectoral and sector-specific actions, and the environment needs to be considered at the core, as part of the solution."
A further milestone came in December 2025, when Member States adopted a resolution on the environmental dimensions of AMR at the United Nations Environment Assembly, the UN's highest decision-making body on the environment.
Prevention must start upstream
The most urgent priority, according to Echeverria, is to prevent antimicrobial pollution before it creates conditions for resistance to emerge and spread. "We need to reduce the release of antimicrobial residues, drug-resistant microorganisms and genes into the environment before they become a challenge. This means tackling pollution at its source - upstream," said Aitziber Echeverria.
She identified four priority economic sectors where targeted interventions could significantly reduce environmental contributions to AMR.
- The first is pharmaceutical and chemical manufacturing, where industrial discharges containing antimicrobial residues must be reduced.
- The second is agriculture and food systems, encompassing terrestrial and aquatic animal production as well as crop production. More sustainable production practices, she argued, can help limit environmental contamination.
- The third is healthcare systems, where responsible antimicrobial stewardship can prevent unnecessary releases.
- The fourth is municipal systems, where untreated or inadequately treated waste and wastewater can contribute to the emergence and spread of resistance.
Together, these sectors illustrate why AMR cannot be addressed through isolated interventions. Pollution generated in one sector can create consequences across human, animal and environmental health.
Environmental surveillance as an early-warning system
Alongside prevention, Echeverria called for stronger environmental knowledge, monitoring and information-sharing to help countries identify emerging threats and direct interventions where they are most needed. "Countries need stronger environmental monitoring and surveillance systems because environmental data can provide an early warning of AMR hotspots and sources, which can help identify where and which interventions are needed."
The establishment of the Independent Panel on Evidence for Action against AMR (IPEA), expected to take place in Abuja at the upcoming Fifth Global High-Level Ministerial Conference on AMR, is another important development in strengthening the evidence base for action.
Breaking down institutional silos
But stronger evidence and ambitious commitments will not be enough unless countries address a fundamental governance problem: environmental authorities are often excluded from national AMR decision-making. Echeverria warned against fragmented policies and regulations that separate environmental priorities from national AMR strategies. "There should be no fragmentation in policies and regulation — at global but most importantly at national level — with AMR incorporated into the environmental agendas and the environment at the core of AMR plans, policies and interventions."
In addition, she emphasised that environmental institutions must have a formal role in national AMR governance mechanisms from the beginning, rather than being consulted only after strategies have been developed. For Echeverria, this is central to making One Health meaningful in practice.
This should also translate into concrete environmental objectives and indicators in national AMR action plans, backed by adequate funding.
Investment is essential, not optional
“Environmental interventions require funding to prevent AMR: strengthening wastewater treatment infrastructure, establishing or improving systems for safe disposal of antimicrobials, supporting laboratory and surveillance capacity, and generating environmental AMR data will help countries make evidence-based decisions and measure progress,” said Echeverria.
Such investments, she argued, should also be connected to broader environmental programmes, including pollution reduction, improved water quality, sound chemical management, better waste management and sustainable production and consumption.
The benefits would extend well beyond AMR prevention. "Addressing environmental drivers of AMR can deliver multiple benefits, including progress on public health, biodiversity protection, water security, and it contributes to tackling the triple planetary crisis of climate change, nature loss and pollution," she said.
Global commitments must deliver local results
The urgency of translating commitments into implementation was echoed by Dr Jean-Pierre Nyemazi, Director a.i. of the WHO AMR Department and Director of the Quadripartite Joint Secretariat on AMR.
"AMR is one of the most urgent global health threats and development challenges. It threatens our ability to treat infections, protect animal and plant health, and produce safe food, and also has an impact on the environment," he said. The scale of the threat is already staggering. Nyemazi noted that bacterial AMR alone was associated with more than 4.7 million deaths in 2021. "These are not just statistics. Behind these numbers are patients, families, farmers and communities."
Dr Nyemazi cautioned that the problem is driven by interconnected failures, including antimicrobial misuse and overuse, inadequate infection prevention, poor water and sanitation, and environmental contamination. "AMR does not recognize borders or sectors."
While the 2024 UN Political Declaration established targets for 2030, including reducing deaths associated with bacterial AMR by 10 per cent and ensuring that at least 60 per cent of countries have funded national action plans, implementation remains a major challenge. "However, let’s be honest. The gap between commitments and pledges versus implementation remains wide," Dr Nyemazi said.
The updated Global Action Plan on AMR for 2026–2036 and the forthcoming Fifth Global High-Level Ministerial Conference in Abuja, Nigeria, from 6–8 December 2026, are expected to provide further momentum.
But, as Dr Nyemazi emphasised, “global pledges matter only when they deliver results in communities”.
One Health must reach the community level
Dr Kefas Samson, Senior Technical Officer and Lead of Multisectoral Coordination at WHO's AMR Department, highlighted the importance of translating global strategies into interventions that reflect national needs and local realities.
He stressed that countries must assess their needs, prioritise and cost interventions, and ensure that implementation is aligned with available resources. Primary healthcare and community-based services also have a critical role in driving sustainable behavioural change, strengthening infection prevention, enabling early diagnosis and ensuring timely and appropriate treatment.
Dr Samson identified inadequate financing, weak surveillance, limited diagnostic capacity, gaps in access to quality-assured antimicrobials and shortages of healthcare workers among the continuing barriers to progress. "The Global Action Plan on AMR 2026-2036 places greater emphasis on coordinated One Health action — and that includes human health, animal health, agriculture, and environment."
Countries cannot afford to treat environmental protection as a secondary consideration in the AMR response, stressed Aitziber Echeverria. "We need stronger collaboration across sectors to reduce environmental pollution from antimicrobials and resistant microorganisms and genes. This is what UNEP is supporting, because all these are must-haves. Environmental action on AMR is not an optional addition to the response. It is a prerequisite for success in addressing AMR with One Health approach. If we do not address the environmental dimensions of AMR, we risk undermining efforts in human and animal health."
"On the contrary, if we invest — and sometimes invest is repurposing ongoing investment and incentive schemes — so, if we invest in prevention, pollution reduction and integrated One Health approaches, we can curb the emergence and spread of AMR while advancing sustainable development and protecting future generations," she said.
Shobha Shukla - CNS
(Citizen News Service)
14 November 2026
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