A One Health framework to assess the economic returns on investment in livestock antimicrobial stewardship

Antimicrobial use (AMU) in livestock plays a critical role in sustaining animal health and productivity, yet its overuse and misuse accelerates the emergence of antimicrobial resistance (AMR), posing systemic threats to public health, economic resilience, and global food security. While existing economic analyses have examined discrete sectoral impacts, they often overlook the complex interconnections between farm-level decision-making, governance structures, and broader macroeconomic dynamics. This perspective presents a One Health economic framework for evaluating the returns on investment (ROI) in livestock antimicrobial stewardship. Drawing on interdisciplinary literature from economics, public health, and veterinary science, we map the pathways through which policy environments, market incentives, and production systems shape AMU and influence its downstream economic consequences. By integrating microeconomic, governance, and macroeconomic perspectives, the framework offers a structured basis for evaluating trade-offs between short-term productivity gains and the longer-term costs of AMR, while identifying cross-sectoral synergies that strengthen public health and economic resilience. Designed for future application in computable general equilibrium (CGE) models, the framework offers a conceptual foundation for integrating antimicrobial stewardship into national development strategies within a One Health approach.