Reframing antimicrobial resistance as a land-system challenge through environmental pathways and climate interactions

Antimicrobial resistance (AMR) is a planetary health challenge, yet land-system change remains overlooked. This review examines how agriculture, urbanisation, waste management, deforestation, aquaculture and climate-driven transitions shape resistance through altered input intensity, habitat reorganisation and enhanced connectivity. It identifies evidence gaps across vulnerable settings and proposes pathway-based surveillance, integrated datasets, longitudinal studies and coordinated interventions to reduce resistance selection, persistence and transmission across connected landscapes, informing research, policy and implementation.