Abstract
Background
Climate change and antimicrobial resistance (AMR) represent intersecting risks to livestock and aquaculture systems, particularly in low- and middle-income countries (LMICs). Climate stressors drive increased antimicrobial reliance, while AMR undermines production resilience. Yet policy responses remain largely siloed: climate adaptation frameworks rarely address antimicrobial use, and AMR action plans give limited attention to climate-related drivers. This review assesses how national policies in LMICs integrate AMR control and climate change adaptation, identifying pathways to strengthen policy coherence.
Methods
A review of 204 national policy documents from 51 LMICs, sourced from the FAOLEX legal database and covering 2015–2025, was conducted. Documents were assessed using an intersectoral policy mention matrix across four integration levels: addressed in isolation, cross-referenced mentions, early integration, and full integration. Findings were complemented by 12 field- based community dialogues and site visits in the Philippines and 18 key informant interviews.
Results
Although regional patterns varied, most policies addressed AMR and climate change separately. Of 204 policies reviewed, 170 addressed the issues in isolation, 21 cross-referenced, and 13 showed early signs of integration; none met full integration. Even early integration was limited to specific activities and was not reflected across governance, financing, and monitoring. Common gaps included the absence of shared objectives, coordinated institutional responsibilities, and surveillance systems that jointly track climate variables, disease patterns, antimicrobial use, and resistance. The Philippine case reflected similar challenges, particularly in the absence of cross-sectoral coordination and surveillance systems, subnational implementation, and sustained financing, with the aquaculture sector remaining underrepresented.
Discussion and policy implications
Integration of AMR control and climate adaptation in animal production systems remain largely conceptual across LMICs. The One Health framework offers a practical institutional bridge, yet its environmental component remains underrepresented in policy and practice. Forthcoming revisions to National Action Plans on AMR, Nationally Determined Contributions, and National Adaptation Plans are timely entrypoints for aligning objectives, surveillance systems, and financing. Meaningful progress will require expanded One Health governance structures incorporating climate-AMR linkages, AMR projects within international climate finance mechanisms, and genuine engagement of local governments, communities, and private sector.