Climate change and antimicrobial resistance in the Western Pacific: a mixed-methods systematic analysis

Area of Science:

• Public Health
• Environmental Science
• Infectious Diseases

Background:

• Antimicrobial resistance (AMR) and climate change are critical global health challenges.
• The Western Pacific Region faces unique vulnerabilities at the intersection of climate and AMR.
• Limited evidence exists on the specific climate-AMR nexus in this region.

Purpose of the Study:

• To systematically investigate the relationship between climate change and AMR in the Western Pacific Region.
• To provide quantitative evidence on climate-driven AMR trends and mortality.
• To identify key drivers and inform regional public health strategies.

Main Methods:

• A three-stage mixed-methods systematic analysis was employed.
• Included a narrative review, a systematic literature review (2000-2025), and quantitative analysis of a longitudinal dataset.
• Regression analysis modeled AMR-attributable deaths based on climatic and socioeconomic factors.

Main Results:

• Increasing temperatures accelerate bacterial growth and resistance, and increase antibiotic misuse.
• Higher temperatures are linked to increased clinical resistance and environmental dissemination of antibiotic resistance genes (ARGs).
• A 1°C temperature rise correlated with higher AMR mortality from CRAB and CRPA; socioeconomic factors showed varied effects.

Conclusions:

• Climate conditions and socioeconomic vulnerabilities jointly influence AMR risks in the Western Pacific.
• Projected extreme weather events may strain healthcare systems and worsen antibiotic misuse.
• Strengthening climate-resilient health systems and integrated AMR-climate surveillance are crucial regional priorities.