Beyond Antibiotics: One Health Education for Tackling Antimicrobial Resistance

Antimicrobial resistance (AMR) is recognized as one of the most urgent global health threats, demanding coordinated, multisectoral responses under the OH framework. Among the multidisciplinary tasks aimed at collectively tackling the AMR crisis, surveillance, research and education stand as major priorities. Education is a strategic pillar of the World Health Organization Global Action Plan, yet a comprehensive synthesis of educational initiatives explicitly grounded in One Health (OH) remains limited. Previous reviews have examined AMR educational interventions focusing on specific strategies, regions, professional groups, or pedagogical tools, but without an OH perspective. This review is the first to comprehensively synthesize educational programmes that explicitly integrate OH principles across different educational levels, target audiences, and learning settings. It also examines the pedagogical strategies used to promote AMR awareness, prevention, and responsible antimicrobial use. A structured literature search (2015-2025) was conducted in Scopus and complemented by institutional sources and citation tracking. Educational initiatives incorporating OH principles, addressing multiple sectors, or promoting interdisciplinary AMR education were narratively synthesized. School-based programmes (e.g., e-Bug, ISGlobal initiatives, Ambientech); public awareness and community education via national strategies such as PRAN; programmes for university students; professional training, and continuing education (e.g., ESCMID, AMR EDUCare); and international online platforms including FAO e-learning programmes and the OH Workforce Academy were examined. Programmes were analysed according to target population, pedagogical approach, sectoral integration, and evaluation methods. Active and experiential methodologies, such as service-learning (e.g., Tiny Earth, MicroMundo) game-based learning, gamification, and interdisciplinary and systems thinking-based learning, consistently enhance knowledge acquisition, systems thinking skills, and awareness of cross-sectoral AMR transmission pathways. Despite all these initiatives, studies on knowledge, perceptions and attitudes about AMR point to clear errors and deficiencies. Key gaps, such as inconsistent curriculum integration, limited integration of environmental dimension and scarce rigorous impact evaluations, persist. Strengthening OH-oriented AMR education requires policy-level curriculum inclusion, cross-sector collaboration, standardized competencies, and robust evaluation frameworks. Embedding education within national AMR strategies is essential to fostering sustained behavioural change and preserving antimicrobial effectiveness across human, animal, and environmental systems.