China's nationwide antimicrobial resistance surveillance networks: a systematic analysis from One Health perspective

Antimicrobial resistance (AMR) poses a growing threat to human, animal, and environmental health, necessitating integrated surveillance systems to effectively address this challenge. Globally, many countries have committed to expanding AMR monitoring under their national action plans, yet the development and alignment of surveillance systems across different sectors remain insufficiently documented, likewise in China with rapid economic transformation and severe health challenges. Using the EPI-Net One Health reporting guideline, we reviewed 13 nationwide AMR surveillance networks in China. The findings demonstrate notable progress in sector-specific surveillance, particularly within human and animal sector. However, gaps persist in environmental monitoring, cross-sector integration, methodological standardization, and data sharing, which constrain the generation of high-quality, comprehensive AMR data. These findings highlight the urgent need for increased investment in advanced technologies like whole-genome sequencing (WGS), alongside broader stakeholder engagement and clearer consensus on data governance and data-sharing mechanisms to strengthen AMR surveillance from One Health perspective.