Strengthening One Health Approaches to Combat Antibiotic Resistance: Gaps, Challenges, and Opportunities

This article was exclusively written for European Sting by Ms. Mechoiteu Jijou Berny is a seventh‑year medical student at the Université des Montagnes in Bangangté, Cameroon. She is affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

Antimicrobial resistance (AMR) arises when microorganisms including bacteria, fungi, parasites, and viruses develop the ability to withstand treatments that were once effective. A subset of this crisis, antibiotic resistance (ABR), occurs when bacteria evade antibiotics, undermining therapeutic success, increasing treatment failures, and driving severe illness and mortality[1]. In 2021 alone, 4.71 million deaths were associated with bacterial AMR, with 1.14 million directly attributable. Projections warn that by 2050, AMR could cause 1.91 million attributable deaths and 8.22 million associated deaths worldwide, underscoring its escalating threat[2].

The rise of ABR jeopardizes human and animal health while destabilizing environmental sustainability. Inappropriate dosing fosters recurrent infections and drives further reliance on antibiotics. Weak infection prevention and control in healthcare facilities allow resistant strains to persist and spread. Meanwhile, environmental contamination intensifies the problem: antibiotics enter ecosystems through human excretion, veterinary waste, and agricultural runoff. Livestock practices such as manure fertilization and wastewater irrigation further disseminate resistant organisms and genes into the agro ecosystem, creating a cycle of resistance across the “One Health Triangle” of human, animal, and environmental health[3].

Figure 1. The challenge of antimicrobial resistance in the concept of One Health [3]

 Addressing ABR requires integrated surveillance and response frameworks. Coordinated strategies must combine antimicrobial stewardship, infection control, sanitation, and robust monitoring across all sectors. Wastewater management is particularly critical, as sub-lethal concentrations of antimicrobial residues promote the persistence of resistant strains.

Mitigation strategies span multiple domains. In human and veterinary medicine, surveillance systems and stewardship programs are vital to optimize antimicrobial use. Pharmaceutical policies should restrict over-the-counter sales, eliminate counterfeit or substandard drugs, and enforce prescription-only regulations. Public awareness campaigns, vaccination programs, and infection prevention initiatives can reduce reliance on antimicrobials. At the environmental level, investment in advanced wastewater treatment technologies is essential, alongside regulatory thresholds for antimicrobial concentrations in water systems[3] 

Artificial intelligence (AI) offers transformative opportunities within the One Health framework. The complexity of cross-sectoral data demands advanced analytical tools capable of integrating heterogeneous datasets. AI can support early detection of resistance markers, enhance clinical decision-making, and optimize stewardship through predictive modelling. Moreover, AI accelerates antimicrobial discovery by identifying novel compounds and guiding drug development. Recent studies highlight eight domains where AI can strengthen the fight against AMR: identifying resistant pathogens and genetic markers, analysing clinical datasets, enabling surveillance and early warning systems, integrating diverse data sources, advancing drug discovery, optimizing stewardship and decision support, guiding resource allocation, and informing evidence-based policy[4]. 

In conclusion, ABR is a global health crisis that transcends disciplinary boundaries. A One Health approach bridging human, animal, and environmental perspectives combined with innovative tools such as AI, is indispensable for mitigating resistance and safeguarding the efficacy of future therapies.

REFERENCES

1. Efforts to Identify and Combat Antimicrobial Resistance in Uganda: A Systematic Review [Internet]. [cited 2025 Nov 25]. https://www.mdpi.com/2414-6366/6/2/86. Accessed 25 Nov 2025

2. Global burden of bacterial antimicrobial resistance 1990–2021: a systematic analysis with forecasts to 2050 – The Lancet [Internet]. [cited 2025 Nov 25]. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01867-1/fulltext. Accessed 25 Nov 2025

3. (PDF) The AMR Pandemic Is Here: Implementation Challenges and Need of the One Health Approach [Internet]. ResearchGate. [cited 2025 Nov 25]. https://doi.org/10.20944/preprints202407.1400.v1

4. Kasse GE, Cosh SM, Humphries J, Islam MS. Leveraging artificial intelligence for One Health: opportunities and challenges in tackling antimicrobial resistance – scoping review. One Health Outlook. 2025;7:51. https://doi.org/10.1186/s42522-025-00170-8

About the author

Mechoiteu Jijou Berny is a seventh‑year medical student at the Université des Montagnes in Bangangté, Cameroon. She is an active public health advocate with a strong commitment to combating antimicrobial resistance (AMR) and advancing infectious disease prevention. As part of the AMR Ambassadors Program for young Africans, she led the development of a dedicated radio program aimed at increasing public awareness on AMR. Berny promotes antimicrobial stewardship, champions the One Health approach, and works closely with communities and health professionals to strengthen understanding of the growing threat posed by drug‑resistant infections.