Pollution and climate change set stage for rise in antimicrobial resistance

Pollution and climate change set stage for rise in antimicrobial resistance

  • A new report from the United Nations Environment Programme illustrates the role that pollution, climate change and biodiversity loss can play in the development of antimicrobial resistance.
  • The compounds used to treat bacterial, viral, parasitic and fungal infections have saved countless lives, but their overuse and their presence in the environment from human waste, agriculture and effluent from the pharmaceutical industry and places like hospitals has given rise to resistance to these chemicals in potentially harmful microbes.
  • If this resistance continues to increase, experts warn that an additional 10 million people may lose their lives by 2050 — about the same number who died of cancer in 2020.
  • The report’s authors recommend stronger safeguards around industrial runoff, better sanitation and more judicious use of antimicrobials to address this potential crisis.

Pollution from a variety of sources is driving up the incidence of resistance to the compounds used to treat infections, according to a report released by the United Nations Environment Programme.

The authors also note that climate change and biodiversity loss help foster the development of antimicrobial resistance, or AMR. They call for systemic societal changes to avoid rendering more of these disease-fighting tools ineffective.

Our reliance on antibiotics and other antimicrobial compounds has created something of a paradox. These chemicals treat bacterial, viral, fungal and parasitic infections, saving countless lives around the world and boosting the production of food crops and livestock. But the use — and overuse in many cases — of these antimicrobials has also come at a cost, nudging along the evolution of potentially dangerous microbes into forms that are more resistant to the medications we throw at them.

“We’re selecting for stronger and more powerful microorganisms,” David Graham, a professor of ecosystems engineering at the U.K.’s Newcastle University and one of the lead authors of the report, said at a press conference ahead of the report’s launch Feb. 7 at a meeting of the Global Leaders Group on Antimicrobial Resistance in Barbados.

Studies show bacterial infections resistant to antimicrobials played a role in the deaths of nearly 5 million people in 2019. The World Health Organization (WHO) considers antimicrobial resistance one of the top 10 threats to global health.

The report’s authors sought to tease apart the complex dynamics by which this resistance develops and to identify the pollution sources that increase the likelihood of more resistance. Effluent from the pharmaceutical industry, hospitals, human waste and agriculture exposes germs to the drugs, giving them more chances to evolve resistance to them.

The presence of other pollutants in the environment, such as heavy metals like zinc used in the production of steel, can also prime the development of resistance to important antimicrobials, and the loss of biodiversity, even at the microbial level, can as well. A warmer global climate may also lead to more widespread resistance, as higher temperatures can encourage the rate at which genes are transferred from microbe to microbe. In addition, the extreme weather the world is already experiencing as a result of climate change can trigger the failure of the barriers, such as sewers, between us and virulent microorganisms.

Untreated sewage entering a waterway in Mumbai, India. Effluent from the pharmaceutical industry, hospitals, human waste and agriculture exposes germs to the drugs, giving them more chances to evolve resistance to them. Image by Mongabay.

“Unfortunately, when you get a flood, for example, those barriers break down,” Graham said. “Once those barriers break, then you’ve got uncontrolled spread in places where AMR doesn’t exist.

“By curbing temperature rises and reducing the extremity of events,” he added, “we can actually then fundamentally curb the probability of evolving new resistance.”

Beyond the need to address climate change, the authors suggest that halting the rise of AMR will require improved sanitation and wastewater treatment, the enhanced ability of industry to contain the release of antimicrobials, resistant microbes and other pollutants, and limiting the use of these chemicals in agriculture when they’re not necessary.

“If you’ve got a healthy animal, you don’t need an antibiotic,” Graham said.

Recent projections suggest that antibiotic use in the animals humans raise for food will increase by 8% by 2030.

“Failing to address the global burden of [antimicrobial resistance], including its environmental dimensions, could take humanity back to an era when even mild infections could become deadly,” the authors write.

Research suggests this resistance could lead to an additional 10 million deaths by mid-century, about as many as the people who died of cancer globally in 2020, according to the WHO. What’s more, the resistance could cost governments trillions of dollars in lost economic productivity and impoverish 24 million more people worldwide, the authors write.

Sunita Narain, the director-general of the Indian nonprofit Centre for Science and Environment, said countries like India are facing the “twin challenge” of needing access to antimicrobials but also dealing with their overuse. She said knowledge of the problems that widespread and excessive use of these compounds can cause gives less-industrialized countries the opportunity to find a different path.

“The cost of cleaning up once you’ve contaminated your environment, your soil, with antimicrobials is extremely expensive,” said Narain, who served as a consultant to the authors of the report. “I think it’s very important that we bring out the environmental aspects of the silent pandemic, but we also move towards the action that we need.”

Banner image: Testing a variety of bacteria for antimicrobial resistance. Image by DFID – UK Department for International Development via Wikimedia Commons (CC BY 2.0).

John Cannon is a staff features writer with Mongabay. Find him on Twitter: @johnccannon

Humans are dosing Earth’s waterways with medicines. It isn’t healthy.


Mulchandani, R., Wang, Y., Gilbert, M., & Van Boeckel, T. P. (2023). Global trends in antimicrobial use in food-producing animals: 2020 to 2030. PLOS Global Public Health, 3(2), e0001305. doi:10.1371/journal.pgph.0001305

United Nations Environment Programme. (2023). Bracing for Superbugs: Strengthening environmental action in the One Health response to antimicrobial resistance. Geneva.

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