One World, One Health: Why Pharma Must Confront AMR and Climate Change Together

Ahead of the 78th World Health Assembly (WHA78), themed One World for Health – we investigated two pressing and increasingly interconnected global health threats: antimicrobial resistance (AMR) and climate change. While each issue is individually recognised as a top policy priority, the compounding effects of climate change on the rise of resistant microorganisms remain under-reported and underestimated across governments, economies, and wider society.

The connection between AMR and climate change is not yet widely understood or integrated into policy. Governments have been slow to address both challenges under a single, unified strategy. A major obstacle is the absence of a global governance mechanism that holds countries accountable for coordinating action on AMR and climate change. Although the World Health Organisation (WHO) actively promotes a One Health approach— recognising the interdependence of human, animal and environmental health—implementation at the national level remains fragmented. This fragmentation is partly structural, embedded in governments’ institutional designs. Climate and health policies, including those related to AMR, often sit in separate government departments, with distinct funding streams, policy agendas, and stakeholder ecosystems. As a result, cross-sectoral coordination is rare, even when the issues are inherently interlinked. This siloed approach makes it challenging to develop cohesive public messaging and policy frameworks that reflect the true complexity of the global health problem.

We pose the notion that AMR and climate change are deeply interconnected challenges that must be tackled jointly to effectively protect global health. As health challenges become more complex and interdependent, pharmaceutical companies can champion integrated solutions – not only due to ethical and scientific responsibility, but because of the strategic opportunities.

While pharmaceutical companies already operate under rigorous frameworks when developing antimicrobials, applying a One Health lens is essential to future-proof these efforts. AMR and climate change are both driven by interconnected human, animal and environmental factors. Ultimately, resistant pathogens do not respect sectoral boundaries – they can emerge in farms, water systems, or the broader environment, before reaching clinical settings and undermining even the most effective drugs. Importantly, more than 70% of antibiotics are used in animals, not humans, and resistant pathogens can transfer across species. Climate change, by altering ecosystems and driving habitat loss, can accelerate these processes. By integrating environmental science, pharmaceutical companies can tap into new diagnostics, surveillance tools, and datasets – enabling a prevention-first model and reducing reliance on antibiotics in the first place. Tackling AMR and climate change positions the life science industry to meet emerging policy expectations and sustainability frameworks, as funders, regulators, and investors increasingly promote integrated, cross-sectoral approaches.

Industry efforts in this space also offer clear business incentives: opportunities for innovation, market leadership, and long-term financial resilience in a shifting regulatory and health landscape. Hence, by tackling AMR and climate change through integrated cross-sectoral action, the industry can contribute to more sustainable and effective solutions – aligning with growing stakeholder expectations for it to play a leading role.

AMR’s increased presence on the global health agenda

As described by the WHO, AMR occurs when bacteria, viruses, fungi, and parasites fail to respond to medicine, as bacteria naturally evolve by adapting to environmental pressures exerted by exposure to antimicrobial agents. Over time, such adaptations enable microorganisms to survive and proliferate despite the presence of treatments designed to eliminate them. As a result of drug resistance, some medicines, such as antibiotics, are rendered ineffective. Importantly, AMR undermines the effectiveness of infection management in oncology and transplant patients, leaving vulnerable groups at elevated risk of untreatable infections. Such infections become difficult or impossible to treat, which increases the risk of disease, severe illness, and death. Without reliable antimicrobials, prophylactic measures fail, and advanced treatments such as chemotherapy and immunosuppression become significantly riskier.
While labelled the “silent pandemic” due to a lack of visibility and urgency, awareness around AMR is advancing on the global health agenda, which the life science industry should take note of. A popular event that industry players attend yearly, the UN General Assembly (UNGA), held the second-ever High-Level Meetings on AMR in September 2024, situating AMR as a higher-priority issue from a planetary health perspective, whilst setting the stage for further progress in 2025. This prioritisation reflects mounting concerns that without urgent action, AMR could render routine medical procedures like surgeries and cancer treatments increasingly dangerous – leading to an estimated 10 million deaths annually by 2050 if left unaddressed, according to the WHO. These multi-stakeholder discussions underscored global recognition of the interconnected nature of AMR and climate change, and in conjunction these events have paved the way for industry action.

The threat of AMR and opportunity for pharmaceutical and life science companies

Although AMR is a natural phenomenon, its main drivers are anthropogenic, caused by the misuse and overuse of antimicrobials to treat, prevent, or control infections in humans, animals, and plants. For example, multiple findings concluded that the widespread use of antibiotics during the Covid-19 pandemic contributed to the AMR crisis. In efforts to combat misuse of antimicrobials more generally, hospitals and regulatory bodies have developed antimicrobial stewardship programmes to promote the responsible use of antimicrobials to decelerate these AMR cases, which are proven to be very successful once implemented. Separately, yearly AMR awareness weeks also act as a key platform for both public and private sector to actively highlight strategies on the importance of responsible antimicrobial use. However, the misuse and overreliance on existing antimicrobials has still spread, exacerbating resistance, and underscoring the urgent need for new agents –an initiative that is hindered by industry roadblocks.

The development of new antibiotics is a costly and time-consuming process, with significant scientific, economic and regulatory hurdles. Pharmaceutical companies face diminishing financial incentives, as antibiotics are used sparingly by healthcare providers to delay natural resistance, limiting their viability for pharmaceutical companies. A well-known example is Achaogen Biopharma, which developed plazomicin for drug-resistant urinary tract infections. Despite its clinical value, low usage to avoid resistance led to poor sales, and the company filed for bankruptcy in 2019. Moreover, the discovery of novel compounds to address resistant pathogens presents significant challenges, as the majority of easily identifiable antimicrobial targets have already been exploited. Additionally, whilst regulatory pathways are essential to ensure safety and efficacy, they often struggle to keep pace with the rapid evolution of antimicrobial technologies such as phage therapy, CRISPR-based antimicrobials, and antimicrobial peptides. Adapting to this pace of change requires more flexible and innovative regulatory approaches, such as adaptive licensing or accelerated approval mechanisms, to avoid delaying promising new therapies, and incentivising the industry further. In the UK, for instance, the MHRA’s Innovative Licensing and Access Pathway (ILAP), re-launched in early 2025, offers a promising regulatory route for antimicrobial innovations by supporting early regulatory engagement and flexible evidence requirements. This pathway currently supports firms like Destiny Pharma, a clinical-stage biotech developing a novel antimicrobial design to prevent post-surgical infections by methicillin-resistant Staphylococcus aureus (MRSA) to be fast-tracked for approval, meaning patients will have earlier access to life-saving medicines.

On the other hand, it is important to recognise that both AMR and climate change are transboundary challenges, and do not stop at national borders, including those of the UK. As such, the regulatory environment should reflect this reality. Establishing a simplified, harmonised global approval process for antimicrobials could help incentivise greater investment and development in this critical area.
It is clear that the life sciences industry is facing hurdles in incentivising the production of new antimicrobials, despite the multiple initiatives that have been put in place to foster innovation, such as push (e.g. R&D grants) and pull mechanisms (e.g. subscription-style payments). Pharmaceutical companies, ultimately accountable to shareholders, are drawn to therapeutic areas with high and predictable returns, such as oncology and obesity, whereas antimicrobials are used sparingly and held in reserve, limiting their market potential. Without more robust, globally coordinated incentives that reflect the commercial realities facing the sector, R&D investments will remain concentrated in other therapeutic areas. Governments must acknowledge and address the disconnect if innovation is to become realistic, sustainable and impactful.

In the 2023 AMR Benchmark – a tool that evaluates how successfully pharmaceutical companies are addressing AMR – it was found that there were three key opportunities for pharmaceutical and life science companies to combat AMR: research and development, responsible manufacturing, and appropriate access and stewardship. Many companies still have room to improve in all these areas, yet there have been some successes since the 2021 Benchmark: further integration of AMR into environmental risk strategy, safer access to certain antimicrobials, and cases of pipeline progression. The latter requires major investment and mobilisation from companies that are still lagging in their pipeline expansion. Investing more into antibiotics may seem like an added cost and a big risk, but it is also a strategic way for companies to protect the efficacy of their current portfolio by reducing the likelihood of resistance emerging to existing products. New antimicrobials can relieve pressure on older drugs, delaying the development of resistance and preserving their utility for longer.

Crucially, resistance to antibiotics can undermine entire treatment pathways. In oncology, for instance, patients undergoing chemotherapy are highly vulnerable to infections. While the shift toward home-based care may reduce some exposure to hospital-acquired infections, offering cost and comfort benefits, many treatments still rely on in-clinic or hospital administration. If the spread of AMR continues, the diminished effectiveness of antibiotics will jeopardise the safety of these treatments, leading to increased complications, longer hospital stays, and higher healthcare costs. This in turn could destabilise care delivery and impact the success, demand, and profitability of a company’s oncology portfolio. Therefore, there is a growing need for public-private partnerships and coordinated global initiatives to incentivise antimicrobial innovation and ensure that treatments – oncology and beyond – remain effective for future generations.

The extent to which climate change exacerbates AMR

Although the literature requires more attention, studies increasingly highlight that the climate crisis is worsening AMR, spanning agriculture, economics, and planetary health. Rising temperatures, changes in humidity, and other environmental changes were shown to accelerate the spread of resistant microbes in water systems and soil and food chains, posing risks to human, animal, and ecosystem health. The effects of climate change are particularly severe for displaced populations, often exposed to waterborne diseases, causing illness and death. In such cases, the absence of robust healthcare systems not only increases vulnerability, but also drives the overuse of antimicrobials, further fuelling the AMR crisis.
There are numerous reasons why a literature gap persists on the intersection of climate change and AMR; for instance, concepts like planetary health and One Health have only recently gained traction on global policymaking agendas, with academic and policy research on climate change and AMR often occurring in silos. Furthermore, areas severely impacted by climate change and AMR often lack strong surveillance systems to collect and analyse longitudinal and real-world data, limiting our ability to make strong conclusions or develop targeted interventions in this space. This makes the WHA78’s theme, One World for Health, particularly powerful in its potential to inspire meaningful and coordinated action in this space.

Gaps in AMR and climate change policy

The limited presence of the life science and pharmaceutical industry at COP29 underscored the insufficient recognition within the sector of the intricate connections between AMR and climate change. As discussions about AMR feature more at high-level multilateral and international conferences, it serves as a reminder that the industry must broaden its involvement and responsibility in preventing AMR proliferated by climate change.

While the AMR epidemic is not as widely recognised as the climate crisis, integrating discussions on AMR within the broader context of climate change can significantly raise awareness about the serious threats posed by AMR. The AMR-climate change nexus featured on last year’s COP29 agenda, highlighting the growing concern among global environmental leaders. COP28 featured the first ever ‘Health Day’ acknowledging the progress to integrate health into climate policy, where 150 nations signed a statement raising the alarm on the detrimental effects of climate change on health.
Pharmaceutical and life science companies should join global health and environment leaders and decision-makers at this year’s COP30 in Brazil. Their attendance could act as a catalyst for multinational action on AMR and climate change, as well as other global health risks. COPs require major industry leaders to bridge the gaps between climate risk and mitigation and economic levers for change. If life science players were to commit to incorporating improved health outcomes into the COP30 agenda and future conferences, nations could come to the table with cross-government and private sector funding opportunities for global health challenges such as AMR. This is the key to navigating these difficult health and climate headwinds.

A call to pharma: integrating AMR and climate change in strategic goals

Climate change and AMR discussions are high on the agenda of the WHA78 in Geneva, positioning the Assembly as a key platform to elevate health’s role ahead of COP30 later this year. The adoption of the legally binding Pandemic Accord, following three years of negotiations, signalled a moment of unity among Member States and marked a key turning point in how global health threats are prioritised. The Accord reinforces a One Health approach, recognising that pandemics, AMR, and climate change are interconnected, transboundary challenges that require innovation, stewardship of global public goods, and coordinated international action.

With the life sciences sector being active and engaged at WHA78, companies should seize the momentum to support policies that align with international health and climate goals. This includes enhancing regulatory harmonisation, strengthening global health leadership, and embedding public health priorities into long-term business strategies. For example, at WHA78 on May 21st, the Novo Nordisk Foundation pledged around 57 million USD to the WHO to support the response to multiple health threats, most notably AMR. While the WHO receives support from various life sciences organisations, this pledge marks a deepening of Novo’s philanthropic partnership with the multilateral health body. In doing so, the Foundation positions itself as a leader in advancing collaborative solutions to global health challenges. Life sciences companies would be well placed to follow this example and consider how strategic partnerships can both advance public health and align with long-term sustainability goals.

For the life sciences industry, the message is clear: addressing AMR and climate change is not just a moral imperative, but a strategic necessity that protects the future of their businesses. The life sciences sector must continue to be an indispensable partner in global health initiatives. Industry stakeholders will increasingly be viewed not only as drivers of innovation, but as collaborative partners, as the world faces growing AMR and a worsening climate crisis. Industry leaders will differentiate themselves by investing in equitable access, innovative and novel treatments, and cross-sector collaboration to limit AMR spread.

By Margaux Nieuwjaer and Liana Riley