Build integrated One Health surveillance for antibiotic use and resistance

Countries should link quality-assured laboratory resistance data with antimicrobial consumption and use in human and animal health, food-chain sampling and targeted environmental monitoring. Systems should use common definitions, protect patient and farm privacy, report uncertainty and return actionable results to clinicians, veterinarians, regulators and communities.

Whole-genome sequencing and wastewater metagenomics can add resolution where affordable and decision-relevant. Surveillance priorities should be tied to response thresholds, since data collection without action does not reduce resistance.