Publication: Policy Options for Antimicrobial Resistance: Exploring Lessons From Environmental Governance
Authors: Isaac Weldon, Kathleen Liddell, Kevin Outterson
Introduction
Antimicrobial resistance (AMR) is a global health crisis. It happens when bacteria and other microbes evolve to survive the drugs meant to kill them. As a result, common infections become harder—and sometimes impossible—to treat. AMR is spreading across borders and sectors, affecting human health, agriculture, and the environment.
At its core, AMR is a shared resource problem. Antimicrobials are a limited resource: the more we use them, the less effective they become. Everyone depends on them, but no one can manage them alone. Our recent publication studied state-led, market-based, and community-driven governance approaches for other shared-resource problems, translating lessons for AMR governance.
Three Collective Action Challenges affecting AMR
Managing AMR means confronting three overlapping global dilemmas:
- Overuse: People, farms, and health systems rely heavily on antimicrobials. But widespread use depletes their effectiveness—a “commons dilemma” where short-term benefits undermine long-term access.
- Unequal access: In many regions, people still lack access to effective antimicrobials. These gaps create vulnerabilities that allow disease to spread—a “weakest link problem,” where everyone is only as safe as the least protected.
- Lack of new drugs: The market offers little incentive to develop new antimicrobials, because they’re expensive to produce and meant to be used sparingly, generating little profit for pharmaceutical companies. This is a “volunteer’s dilemma”—everyone hopes someone else will invest, but few are willing to go first.
AMR is Structurally Similar to Climate, Water, and Biodiversity
AMR isn’t the only problem that looks like this. Climate, water, and biodiversity are also shared global resources facing collective overuse, unequal access, and underinvestment. These areas have long struggled with questions of:
- Who bears responsibility for protecting the resource?
- How can we align local actions with global goals?
- What mix of government, market, and community tools will work?
Climate, Water, and Biodiversity Governance Offer Lessons for Addressing AMR
Decades of climate, water, and biodiversity governance offer direct lessons for addressing AMR. Climate governance shows how market tools like carbon taxes and tradable permits can help curb emissions (overuse) and how policy stability can generate favourable conditions for private investors (investment). Water management shows how public infrastructure and regulation can lead to service provision (access and investment). Biodiversity conservation shows how community leadership and benefit-sharing can create equitable partnerships for sustainable use and long-term funding (overuse, access, and investment).
In each case, governance approaches had to be tailored to the specific resource, context, and scale of the problem. There is no one-size-fits-all fix. In environmental governance, effective solutions combine:
- State action (laws, investments),
- Market incentives (pricing, trading), and
- Community participation (stewardship, local governance).
Conclusion:
AMR shares these same structural features and requires similarly blended solutions.
What works in one setting—like a tax on antibiotic use—might not work in another. But the tools exist. They just need to be applied in a way that fits local conditions while supporting global goals.
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