Abstract
Antimicrobial resistance (AMR) is a critical global health threat that transcends human, animal, and environmental sectors, necessitating a One Health approach. AMR arises from the misuse and overuse of antimicrobial agents in clinical, veterinary, and environmental settings, resulting in treatment failures and heightened mortality rates. By 2050, AMR is projected to cause 10 million deaths annually and incur a global economic loss of 1 trillion USD. Low- and middle-income countries (LMICs) are expected to bear a significant burden, potentially accounting for 5 million of these deaths and facing substantial economic challenges due to limited access to healthcare resources and second-line antibiotics. In human health, excessive antibiotic prescriptions and hospital-acquired infections have been identified as major drivers of resistance, exacerbated by poor infection control and the lack of rapid diagnostic tools. Similarly, in veterinary medicine, the use of antimicrobials in livestock for disease prevention and growth promotion contributes significantly to AMR. Resistant bacteria from animals can transmit to humans through direct contact, the food chain, and environmental contamination. The environment further amplifies resistance through pharmaceutical waste, wastewater treatment inefficiencies, and the accumulation of resistant genes in ecosystems. Global efforts to address AMR include regulatory frameworks for prudent antimicrobial use in agriculture, human medicine, and waste management, alongside research into alternatives like phage therapy, immunotherapies, and improved diagnostics. Future solutions must focus on innovation, public engagement, and multi-sectoral collaboration to tackle the rising tide of resistance. The aim of this review is to explore the issue of Antimicrobial Resistance (AMR) from a One Health perspective, highlighting the challenges faced by low- and middle-income countries (LMICs).

Key words: Antimicrobial resistance, One Health, antibiotic overuse, veterinary medicine, environmental AMR, global health, pharmaceutical waste, aquatic ecosystems