Antimicrobial Resistance as a Public Health Systems Challenge
- 1Nursing Department, Faculty of Medicine, Kauno kolegija, Higher Education Institution, Kaunas, Lithuania
Abstract
Antimicrobial resistance (AMR) has emerged as one of the most complex and urgent threats to global public health, undermining decades of medical progress in the treatment of infectious diseases. While traditionally framed as a microbiological or clinical issue, AMR is increasingly recognized as a systems-level challenge shaped by interconnected human, animal, environmental, and healthcare factors. This presentation explores AMR through a public health systems lens, emphasizing how structural determinants—such as antibiotic prescribing practices, healthcare infrastructure, infection prevention and control (IPC) capacity, pharmaceutical regulation, agricultural antibiotic use, and environmental contamination—collectively drive resistance dynamics at the population level. The persistence and spread of resistant organisms are further amplified by global mobility, urbanization, and inequities in healthcare access and quality. A key argument is that fragmented responses focusing solely on individual behavior or clinical stewardship are insufficient. Instead, effective AMR mitigation requires integrated governance across sectors, aligned with the One Health framework, and supported by coordinated surveillance systems capable of linking human health, veterinary data, and environmental monitoring. Strengthening laboratory capacity, improving diagnostic stewardship, and ensuring equitable access to effective antimicrobials are central pillars of this approach. The presentation also highlights the importance of health system resilience, including preparedness for outbreaks of resistant infections, workforce training, and the implementation of evidence-based antimicrobial stewardship programs. In addition, policy interventions at national and international levels are examined, with emphasis on regulatory mechanisms, economic incentives, and global coordination.
Key messages: • Antimicrobial resistance is not only a clinical problem but a systemic public health challenge driven by interconnected human, animal, environmental, and healthcare factors.
• Effective control of antimicrobial resistance requires integrated, cross-sectoral action—combining stewardship, surveillance, and health system strengthening within a One Health framework.
Related
- Reptiles in the One Health ecology of antimicrobial resistance, with insights into zoonotic pathogens: reservoirs, transmission pathways, and public health implications
- Disrupting antimicrobial resistance in food systems from a One Health perspective: A complex systems analysis in Canada, Senegal and the Netherlands
- From discovery to preparedness: reframing antimicrobial resistance as a global governance challenge
- Antimicrobial resistance at the animal / environment interface: phenotypic detection and persistence of ESBL and carbapenemase producing Enterobacterales in Irish cattle systems
- Phage-Inducible Chromosomal Jumbo Islands (PICJIs) spreading antimicrobial resistance, host-adaptation factors and defense systems, a novel satellite family of nucleus-forming Chimalliviridae
BibTeX
@article{balasova2026antimicrobial,
title = {{Antimicrobial Resistance as a Public Health Systems Challenge}},
author = {E Balasova},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.1256},
url = {https://doi.org/10.1093/eurpub/ckag169.1256},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Antimicrobial Resistance as a Public Health Systems Challenge
AU - E Balasova
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.1256
UR - https://doi.org/10.1093/eurpub/ckag169.1256
AB - Antimicrobial resistance (AMR) has emerged as one of the most complex and urgent threats to global public health, undermining decades of medical progress in the treatment of infectious diseases. While traditionally framed as a microbiological or clinical issue, AMR is increasingly recognized as a systems-level challenge shaped by interconnected human, animal, environmental, and healthcare factors. This presentation explores AMR through a public health systems lens, emphasizing how structural determinants—such as antibiotic prescribing practices, healthcare infrastructure, infection prevention and control (IPC) capacity, pharmaceutical regulation, agricultural antibiotic use, and environmental contamination—collectively drive resistance dynamics at the population level. The persistence and spread of resistant organisms are further amplified by global mobility, urbanization, and inequities in healthcare access and quality. A key argument is that fragmented responses focusing solely on individual behavior or clinical stewardship are insufficient. Instead, effective AMR mitigation requires integrated governance across sectors, aligned with the One Health framework, and supported by coordinated surveillance systems capable of linking human health, veterinary data, and environmental monitoring. Strengthening laboratory capacity, improving diagnostic stewardship, and ensuring equitable access to effective antimicrobials are central pillars of this approach. The presentation also highlights the importance of health system resilience, including preparedness for outbreaks of resistant infections, workforce training, and the implementation of evidence-based antimicrobial stewardship programs. In addition, policy interventions at national and international levels are examined, with emphasis on regulatory mechanisms, economic incentives, and global coordination. Key messages: • Antimicrobial resistance is not only a clinical problem but a systemic public health challenge driven by interconnected human, animal, environmental, and healthcare factors. • Effective control of antimicrobial resistance requires integrated, cross-sectoral action—combining stewardship, surveillance, and health system strengthening within a One Health framework.
SN - 1101-1262
SN - 1464-360X
ER -