The Lancet Planetary Health, March 2025

Nature-based solutions to address climate change and antimicrobial resistance

We commend Bianca van Bavel and colleagues for synthesising the literature on linkages between climate change and antimicrobial resistance (AMR). The authors show how AMR can be both a consequence and a cause of climate change and describe shared drivers, including land use change and intensive forms of aquaculture and agriculture.

These drivers and underlying societal forces (such as urbanisation, industrialisation, and extractive capitalism) not only contribute to both climate change and AMR, but also other environmental challenges. Earth systems are faced with the triple planetary crisis of climate change, pollution, and biodiversity loss, and AMR is entangled with all of these. Pharmaceutical and agricultural waste, which contain residues of biocides and antimicrobials, pollute the environment and contribute to selective pressure for antimicrobial resistance, whereas pollution by human and animal faecal waste contributes to the dysbiosis of soils and waterways and the transmission and dissemination of AMR. The application of biocides and antimicrobials not only affects biodiversity in terms of plant and insect species and the ecosystems that depend on them, but also in terms of microbial ecosystems, which are essential for healthy aquatic and terrestrial environments.