Evaluation of Climate Change Impacts on AMR Using a Planetary Health Framework (CLIMAR)

Climate change and antimicrobial resistance (AMR) are complex challenges that pose significant threats to society. The triple planetary crisis of climate change, pollution and impacts on biodiversity, highlighted by the UN, are likely to impact AMR emergence and transmission. It is essential to account for the social, cultural and physical environments of AMR, including the impacts of climate change. Increasing temperatures and changing patterns of rainfall will affect AMR evolution and transmission, patterns of migration, and will change food production, land use and freshwater use. Conversely, antimicrobials may impact microbial geochemical cycling, such as nitrogen cycling in soils and methane production in ruminant microbiomes. These interactions raise the intriguing possibility that a bidirectional relationship exists between climate change and AMR.

The Climate AMR Network (CLIMAR) will examine the relationship between climate change and AMR via a Planetary Health framework that examines AMR in terms of planetary boundaries within which humans and ecosystems can continue to develop and thrive. Network themes will include climate change, novel chemical and biological entities (including antimicrobials and AMR bacteria), impacts on microbial biodiversity, land system changes and freshwater use, all of which have mechanistic links with AMR. This Planetary Health framing builds on the One Health approach (which interweaves the health of humans, non-human animals and environments) by adding additional layers of mechanistic understanding, urgency, social dimensions and intergenerational justice, whilst also providing a transdisciplinary framework based on five Planetary Health pillars: (1) interconnection within Nature, (2) the Anthropocene and health, (3) equity and social justice, (4) movement building and systems change, and (5) systems thinking and complexity. These five Pillars will inform our activities including white paper production and research projects by focusing on key knowledge gaps in AMR, climate change and their intersection. These objectives will be informed by an initial systems mapping exercise that will identify the relationships between climate change and AMR, facilitating calibration of network objectives and incorporating input from members joining post-award. It will be necessary to ensure that CLIMAR network activities complement, rather than replicate, planned activities in all other funded networks. We aim to integrate this consideration into this network's activities from its inception. Additionally, professional communications expertise in combination with specialisation in policy development will ensure real impact and change results from network activities.

Bringing a Planetary Health perspective to AMR, with a specific focus on interactions with climate change, provides an opportunity to develop AMR narratives beyond a One Health framing. The latter recognises the linkages between "human health", "animal health" and "environmental health" but does not fully convey the fundamental contribution of planetary processes or social determinants, encapsulated by the planetary boundaries and transdisciplinary pillars, to the mental models that facilitate reasoning and decision making. If we aspire to achieve transdisciplinary solutions and interventions, and to reduce AMR infections whilst promoting drug discovery and innovation of alternatives to stay one step ahead of AMR, we need evidence to support decision making as well as compelling narratives to facilitate understanding and encourage action; recognising that solutions may be found in domains that are traditionally outside the interests of AMR researchers.