Navigate SDG conflicts on antibiotic resistance

Antibiotic resistance (ABR) is recognized as one of the most complex global challenges of our time. It is responsible for 1.3 million deaths annually and disproportionately impacts low- and middle-income countries (LMICs). The development and spread of resistance is promoted by the misuse of antibiotics across a broad spectrum of interconnected sectors, including health, agriculture, food, water, sanitation, and the environment.

The continued increase of antibiotic resistance can severely undermine the achievement of the Sustainable Development Goals (SDGs), especially those concerning social and economic development, poverty alleviation, and equity. While the 2030 Agenda for Sustainable Development interacts closely with ABR policies, the frameworks for attaining SDGs and resistance reduction have largely been developed and implemented independently in many countries. This isolation often leads to a lack of coordination and potential misalignment between policy goals, resulting in suboptimal outcomes.

Numerous conflicting objectives exist between and within interventions focused on ABR within the scope of the SDGs, as well as between ABR mitigation goals and SDGs with other primary focus. For example, the inherent access-excess conflict which means that efforts to ensure responsible use can restrict access to antibiotics in settings with a high disease burden where they are most needed. Another example is when efforts to increase productivity and food security by increasing the density of animals and antibiotic use are conflicting with ABR policy that addresses food security by reducing animal density and promoting ecological intensification strategies.

Fully exploring and systematically addressing these conflicting objectives and policy misalignments is a necessary, though often overlooked, area in the ABR research agenda. In the context of decreased global health financing, the necessity for integrative action, synergistic approaches, and transdisciplinary collaboration has become increasingly critical.

The transdisciplinary collaboration platform “BRIDGE-ABR” seeks to make the goal conflicts between and within ABR and the SDGs more visible, while strengthening the research-to-policy and deliberation nexus for developing sustainable solutions. Ultimately, BRIDGE-ABR will serve as an innovative mechanism to support the development and implementation of ABR policies, particularly in LMICs, and inform global ABR and SDG policy deliberations. The specific objectives include exploring and mapping the conflicting objectives related to ABR and sustainable development, and building a transdisciplinary collaborative research network.

BRIDGE-ABR is led by ReAct (a global network dedicated to facilitating action on ABR in LMICs), in cooperation with Uppsala University’s Center for Health and Sustainability and the Stockholm Resilience Centre.