February 06, 2026
Overview
Climate change and antimicrobial resistance (AMR) are two major global health threats, yet how they are connected remains poorly understood. Rising temperatures and extreme weather events are increasing the spread of infectious diseases and placing pressure on health, agricultural, and environmental systems, which can drive greater use of antibiotics and other antimicrobials.
This review article by OHT’s Dr. Erta Kalanxhi and Dr. Ramanan Laxminarayan explores the growing evidence linking climate change to AMR.
The Question:
Does climate change, especially rising temperatures and extreme weather events such as floods and heatwaves, contribute to the emergence and spread of AMR?
The Findings:
The authors explain that climate change and antimicrobial resistance (AMR) are not separate problems. They interact and make each other worse.
- Extreme weather can exacerbate the spread of infections.
As temperatures rise and extreme weather events such as floods, heatwaves, and droughts become more frequent, conditions become more favorable for the spread of infections, including those caused by drug-resistant bacteria.
Flooding can contaminate water sources with sewage and resistant bacteria. Heatwaves can help bacteria survive and multiply faster. Droughts can reduce access to clean water and sanitation infrastructure. Together, these changes allow drug-resistant germs to move more easily between people, animals, food systems, and the environment.
- More infections mean more antibiotic use.
Floods, droughts, and heatwaves can increase the spread of infections. When more people and animals get sick, antibiotics are used more often. In farming, climate stress can lead to higher disease burden in livestock, increasing antibiotic use in animals. This higher and often unnecessary use of antibiotics accelerates the development of resistance.
Climate change can weaken the body’s ability to fight infections. Heat stress, food insecurity, and malnutrition reduce immunity. Extreme weather can also disrupt health services, making it harder for people to access timely care. As a result, infections last longer and are harder to treat, increasing reliance on antibiotics.
- Antibiotic use in agriculture affects human health.
Antibiotics used in animals and crops can contribute to the spread of AMR. Resistant bacteria can spread through food, water, soil, and waste, eventually reaching humans.
Climate pressures on agriculture may increase antibiotic use, strengthening these pathways between animal health, environmental health, and human health.
- Social and structural factors fuel AMR.
Poverty, poor sanitation, unsafe water, and limited access to health care create conditions where infections spread easily, and antibiotics are misused.
The authors highlight that tackling this dual crisis requires stronger implementation of proven public health measures. Clean water and sanitation can reduce the risk of infections before antibiotics are needed. Vaccination prevents disease and lowers antibiotic demand. Better diagnostics can help ensure antibiotics are used only when necessary and correctly.
Ensuring access to effective antibiotics, improving nutrition, reducing inequality, and strengthening health systems and water and sanitation infrastructure make communities healthier overall. Healthier populations are better able to prevent infections, use antibiotics responsibly, and cope with climate-related health shocks.
Read the review article in Nature Reviews Microbiology here.
