Will a warmer and less biodiverse world give pathogens new opportunities, and do we have the tools to confront disease? This report discusses the complex intersection of three planetary crises and calls for urgent action to slow resistance to antimicrobial drugs – an obvious public health emergency.

Antibiotics and other antimicrobials have been a global success story, underpinning industrial agriculture and modern medicine, to the point where many pathogens are not considered particularly alarming.

However, overuse of these important compounds has led to an increase in the emergence of drug-resistant microbes, with the strongest surviving and multiplying. If these ‘superbugs’ continue to spread, we will again be at risk from simple infections and routine surgeries.

At the same time, research suggests over half of known human pathogenic diseases can be aggravated by climate change.1 Ultimately, a warmer world with more extreme climate events and reduced biodiversity is likely to leave populations exposed to different pathogens. Our reliance on antimicrobials as a quick fix could mean we lack effective treatments.

At present there is no international scientific body overseeing the management of antimicrobials, and attention to antimicrobial resistance (AMR) is lacking in crucial multilateral agreements. Omitting AMR is a major failure of national and corporate governance. Like the climate and biodiversity crises, it needs better global governance mechanisms to confront it.

Addressing AMR needs a whole-of-society approach, including focused attention from investors. We have an important role to ensure the companies in which we invest consider antimicrobials and AMR. 

Investors need to be made aware they face material risks in companies that do not appreciate how fast AMR is growing, its impacts, and that risk is accruing for those ill-prepared for tighter restrictions on antimicrobial use. The COVID-19 pandemic shows how a global public health crisis is a systemic risk from which portfolio diversification offers little or no protection. As such, diversified portfolios are at risk from AMR proliferation, even when individual company contributors in those portfolios are not themselves at material financial risk.

Key policy asks

To address AMR in a warming world with reduced biodiversity, we are calling for:

  1. An international panel of scientists to address AMR, modelled on the Intergovernmental Panel on Climate Change (IPCC).
  2. A ban on the use of antimicrobials in agricultural supply chains for prophylactic treatment and growth stimulation, modelled on the Montreal Protocol.
  3. Global leadership from the G7, G20 and G77. Under the UK G7 Presidency, finance ministers committed to strengthen antimicrobial development through ‘pull’ incentive mechanisms for the developers of novel antimicrobials; we seek further progress to ensure rewards are tilted towards societal value rather than product volume.
  4. Coherent national responses, where governments embed antimicrobial stewardship (AMS) in health, economic, trade and financial decision-making processes and within regulatory and legislative architecture.
  5. Tighter standard setting and enforcement of water quality related to wastewater from antibiotic use and the production of antibiotics in watercourses and public bathing areas.

Download ‘Confronting a permacrisis?’ to understand:

  • Why existing antimicrobials are becoming less effective
  • The complex ways in which the climate and biodiversity crises are impacting the spread of pathogens, and why we need to ensure effective disease response
  • Why failing to address the permacrises will come at a high cost, in terms of lives lost and value destruction

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