Antimicrobial resistance stands out as one of the most formidable challenges confronting society. “When this happens, our medicines stop working to treat infectious disease,” said Isaac Weldon, a Ph.D. graduate from York University. “What makes it a problem is that human activities are making this process happen much faster, worsening the problem.”
Weldon belongs to a team of researchers who contend that focusing solely on antimicrobial resistance as a medical issue is insufficient. They suggest that a change in mindset is required to minimize the most serious consequences.
“We propose a paradigm shift where we approach the problem of [antimicrobial resistance] as a sustainability challenge rather than a medical challenge,” said Weldon. “Antimicrobials are crucial for promoting human health, but the problem of [resistance] arises as part of the fundamental relationship between human societies and invisible microbial.
“When we see microbes are part of the planet’s ecosystem, we can see the problem […] as a challenge about our never-ending relationship with the natural world, much like climate change and biodiversity loss,” he continued. “This different perspective opens the possibility of focusing on the social drivers of antimicrobial use, rather than solely on the medical response to infectious disease.”
How do we live with microbes?
The COVID-19 pandemic demonstrated how quickly germs can spread globally as a result of our interconnectedness. “If a highly infectious resistant pathogen emerged, then it could follow the same paths of human movement as COVID-19 and spread rapidly around the world,” said Weldon.
Antibiotics play a vital role in treating infections and are widely used as effective medicines. However, if they become ineffective, infections that were previously treatable can become untreatable and even fatal, thereby increasing the risk associated with routine medical procedures such as chemotherapy and surgery.
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According to Weldon, the prevailing issue is that the global focus is mainly on developing new drugs to treat resistant microbes, which is undeniably important but only a partial solution.
“The problem is that existing medicines are becoming ineffective faster than new drugs are coming out, which means that if we only focused on innovation for new antimicrobials, the already inadequate rate of innovation would need to be radically and perpetually accelerated to keep pace with the rising demand for new therapies,” he said. “Instead of trying to innovate our way out of this challenge, our approach suggests that we need to create more sustainable practices so that we are less reliant on antimicrobial drugs. Less use means less resistance.”
This approach ultimately means that society must learn to live alongside microbes. But what does this mean exactly? “To some extent, antimicrobial resistance is inevitable,” said Weldon. “However, whether it turns into a big social problem depends on how humans and germs interact. Currently, we use antimicrobials in so many different aspects of life that we are interacting with germs in an unsustainable way.
“Living more harmoniously with microbes means recognizing that our actions affect microbial ecosystems, which in turn affect us through resistant or new zoonotic diseases. [We] call into question the underlying social reasons for our currently high use of antimicrobials. Transforming these practices to be less reliant on antimicrobials is crucial.”
Weldon and his colleague Steven Hoffman suggest that the current global approach to tackling antimicrobial resistance needs an overhaul to address the issue effectively. The causes and consequences of antimicrobial resistance make it a human health, animal health, agricultural, environmental, developmental, and trade issue, with no single global institution equipped to address it comprehensively. In their paper published in Perspectives on Politics, they explain that there are several instances of overlapping and sometimes conflicting principles, norms, rules, and procedures worldwide that have both positive and negative consequences.
The duo emphasizes that there are no “silver bullets” to solve the issue, and problem-solving must incorporate the situations and health challenges of diverse populations. This is in contrast to the current approaches that tend to apply one-size-fits-all solutions. They also argue that diversifying approaches and practices could help us discover what works when and where, even though the best way to tackle antimicrobial resistance remains unknown.
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“Instead of engaging in an unwinnable arms race — where microbial evolution typically outstrips our ability to develop and distribute new therapies — shifting our approach to designing social systems that can optimize antimicrobial use, minimize [resistance], and maximize the time-limited effectiveness of antimicrobial drugs offers better chances of achieving sustainability,” they wrote. “Without such changes, our response […] will remain a reactive one, always struggling to outpace microbial evolution rather than sustainably managing it.”
This article explores how institutions can better align with ecological and microbial systems to address global health challenges like AMR. It proposes designing institutions that enable harmonious coevolution with microbes, minimize socioecological contradictions, and maximize the effectiveness of antimicrobial treatments. The article identifies opportunities to transform the prevailing principles, norms, rules, and procedures by which AMR is currently governed and suggests that new institutions could help minimize human-induced disease mutations caused by AMR.
This news is a creative derivative product from articles published in famous peer-reviewed journals and Govt reports:
References:
1. Weldon I, Hoffman SJ. “Fit for Purpose?” Assessing the Ecological Fit of the Social Institutions that Globally Govern Antimicrobial Resistance. Perspectives on Politics. Published online 2024:1-22. doi:10.1017/S1537592723002906
2. Agathangelou, Anna M. 2016. “Bruno Latour and Ecology Politics: Poetics of Failure and Denial in IR.” Millennium: Journal of International Studies 44 (3): 321–47. DOI: 10.1177/0305829816643173.
3. Agathangelou, Anna M. 2021. “On the Question of Time, Racial Capitalism, and the Planetary.” Globalizations 18 (6): 880–97. DOI: 10.1080/14747731.2021.1906006.
4. Aggarwal, Vinod K. 1998. “Reconciling Multiple Institutions: Bargaining, Linkages, and Nesting.” In Institutional Designs for a Complex World: Bargaining, Linkages, and Nesting, ed. Aggarwal, Vinod K., 1–31. Ithaca, NY: Cornell University Press. DOI: 10.7591/9781501733123.
5. Alter, Karen J., and Raustiala, Kal. 2018. “The Rise of International Regime Complexity.” Annual Review of Law and Social Science 14 (1): 329–49. DOI: 10.1146/annurev-lawsocsci-101317-030830.
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