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With or without tesla, more e.v. chargers are coming.

Experts say that a new wave of electric vehicle charging stations are coming soon, even after Tesla gutted its charger team.

By Manuela Andreoni

Last week, Tesla laid off most of its electric car charging team , raising doubts about the feasibility of the Biden administration’s ambitious E.V. expansion plans.

Though Tesla accounts for more than half of the fast E.V. chargers currently installed in the United States, and though it has continued to build them faster and cheaper than anyone else, the E.V. charging market may no longer need Tesla to lead it.

In fact, experts I spoke to believe the E.V. charging industry is set to expand quickly over the next few years. Let me explain why.

At first, Tesla’s move seemed like a blow to a sector that may seem like it’s struggling to grow despite the $7.5 billion investment from the bipartisan infrastructure law passed by President Biden in 2021. The administration’s goal is to build a network of a half million fast and slow chargers in the country by 2030, more than double what the U.S. has today . But roughly two and a half years after the bill’s passage only eight federally funded charging stations have opened in six states, according to government data.

Elon Musk, Tesla’s C.E.O., hasn’t explained why he decided to cut back on charger construction, but some analysts interviewed by my colleagues Jack Ewing and Ivan Penn said he had probably concluded that it would become harder to make money from charging as more companies entered the market.

As Ewing and Penn wrote, last year all major automakers selling cars in North America agreed to use the charging plug developed by Tesla, which has a reputation for being reliable and easy-to-use.

That leaves the question I set out to answer. What’s holding back the expansion of America’s electric charging infrastructure? Spoiler alert: The picture isn’t nearly as grim as it may seem.

“We’re not seeing a lag in process or progress,” Ellen Kennedy, a transportation expert at RMI, a clean energy think tank, told me. “I think that people have been taking a dim view of this without actually considering that what has been happening is amazing.”

Jumping through hoops

You might think Kennedy is being overly optimistic, but she’s not alone in thinking the U.S. is turning the corner on E.V. chargers.

My colleague Ewing, who has been covering automakers for decades, told me he has been hearing much of the same thing from experts. “A lot of people told me that the charger infrastructure has a momentum of its own,” he said. “Things are going up pretty fast.”

Including the federally funded program, the U.S. has added an average of about 2,800 fast and slow charging ports a month over the past year, according to government data . (A charging station can have several ports.) Many companies are excited, Ewing said, about the prospect of building out E.V. stations that can offer entertainment, dining and shopping options for drivers. That’s already happening in Norway .

The point of the federal government’s program isn’t simply to add more chargers to the network, but rather to guarantee there is an equitable distribution across the country, and to match charging infrastructure to demand.

“The charging networks, you know, just aren’t building these charging stations where there’s very little E.V. traffic,” Loren McDonald, the C.E.O. of EVAdoption, an industry data and analysis company, told me. “But it’s a chicken and egg thing, and that’s what this program is trying to solve.”

In a statement, the Joint Office of Energy and Transportation, which is responsible for the federal charger program, said, “We want to get it right to ensure we have a charging network that makes it easier for Americans to find a charge than to fill up on gas.”

The obstacles remaining

Still, coordination between the federal government, states and utilities can take time. Most of the money for E.V. chargers is federal, but states are the ones that need to spend it. And then, utilities must connect charging stations to the grid.

Utilities often delay projects. It can take months after a station is built for the local utility to connect it to the grid. A shortage of transformers and switch gears can add another layer of delays.

The good news is that every state, as well as Puerto Rico and Washington, D.C., have presented plans for how they will spend federal resources. But staffing can be an issue. States with high E.V. adoption, like New York, have more experienced staff handling charger expansion efforts than states where fewer people own electric cars, such as South Carolina.

The layoffs at Tesla won’t help any of this go faster. But the company picked up only 14 percent of the contracts from the federal charger program so far, according to EVAdoption. Dozens of competitors, like Francis Energy and Love’s Travel Stop, are working to build the rest.

Overcoming these obstacles is taking time. But all the experts I’ve spoken to expect that to change soon.

Right now, federally funded new stations are opening roughly one a month. McDonald said he expects them to open once a week or once a day by the end of the year.

McDonald also pointed out that public chargers, some of which can recharge a battery in less than half an hour, aren’t where most E.V. charging happens. Most charging happens at home, at work or wherever people park, using slower chargers that can take several hours to charge a car up, but get the job done.

The Biden administration’s “messaging has perhaps overly focused on the fast charging aspect of it,” McDonald said. “The biggest sort of challenge is, well, just education.”

For people considering buying an electric car, seeing charging stations pop up everywhere may help dispel some of their concerns. “We have this saying in the industry that the charger anxiety has replaced range anxiety,” McDonald said.

Still, when it comes to the Biden administration’s expansion plans, McDonald said “ it actually is fair to say that by and large, the program is on track .”

Today on The Daily: Our warming oceans

Ocean temperatures have been hitting record highs for more than a year now, puzzling scientists and raising the prospect of cataclysmic changes to life on Earth.

On Tuesday’s episode of The Daily , David Gelles and Raymond Zhong explain why the oceans are so hot, how the heat is already upending marine life and weather patterns, and what even bigger changes might be in store.

Climate change has been making oceans warmer for decades. But starting last March, scientists noticed a sharp jump in sea surface temperatures. Oceans have absorbed much of the excess heat produced by global warming, but that alone doesn’t explain the spike recorded over the past year.

Another factor was likely the current El Niño cycle , which typically has an overall warming effect on the world’s oceans. Still another likely cause has been the recent changes in shipping regulations that led to reduced air pollution over the North Atlantic, which counter-intuitively allowed more of the sun’s energy to reach the ocean, warming it up. But even when factoring in all those dynamics, scientists are still perplexed by the record heat .

All that extra heat is already having effects. As Catrin Einhorn has reported, coral reefs around the world are experiencing a mass bleaching event . Corals are vitally important parts of marine ecosystems, and responsible for some $2.7 trillion of economic activity. Their disappearance is a problem for the oceans and humans alike.

The warm oceans are also expected to contribute to an active hurricane season. As Judson Jones reported last month, a key area of the Atlantic Ocean where hurricanes form is abnormally warm , conditions that one leading scientist called “unprecedented,” “alarming” and an “out-of-bounds anomaly.”

Even bigger changes could be in store. A key current that moves warm water from the equatorial region up into the North Atlantic is showing early signs of collapsing . The last time that happened, more than 12,000 years ago, Europe was plunged into an ice age.

Listen to the whole episode here.

More climate news

Shell sold millions of carbon credits, for carbon dioxide removals that didn’t actually happen, to Canada’s largest oil sand companies, the Financial Times revealed.

The Environmental Protection Agency proposed to ban a pesticide after ProPublica showed that the government was ignoring the bug killer’s impacts on children’s brains .

Workers producing clothes for brands like Primark, H&M and Old Navy told Grist that they are struggling with rising temperatures .

Thanks for being a subscriber.

Read past editions of the newsletter here .

If you’re enjoying what you’re reading, please consider recommending it to others. They can sign up here . Browse all of our subscriber-only newsletters here . And follow The New York Times on Instagram , Threads , Facebook and TikTok at @nytimes.

Reach us at [email protected] . We read every message, and reply to many!

Manuela Andreoni is a Times climate and environmental reporter and a writer for the Climate Forward newsletter. More about Manuela Andreoni

Learn More About Climate Change

Have questions about climate change? Our F.A.Q. will tackle your climate questions, big and small .

Cattle ranches have ruled the Amazon for decades. Now, new companies are selling something else: the ability of trees to lock away  planet-warming carbon.

Paris is becoming a city of bikes. Across China, people are snapping up $5,000 electric cars. Here’s a look at a few bright spots  for emission reductions.

In theory, online shopping can be more efficient  than driving to the store. But you may still want to think before you add to cart.

“Buying Time,” a new series from The New York Times, looks at the risky ways  humans are starting to manipulate nature  to fight climate change.

Did you know the ♻ symbol doesn’t mean something is actually recyclable ? Read on about how we got here, and what can be done.

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The difficult daily water ritual

• Von Harriet Ongaki

For most residents of Kisumu, especially in the informal settlements, searching for water is a big chunk of their lives. Getting a regular supply of clean drinking water that is affordable is not easy. Many residents don’t make a lot of money, and a significant portion of it goes to food and water. This leaves little room for savings and investments to improve their lives.

“I have no time to play with my friends after school,” Atieno says. “A lot of my time is spent queuing for water and helping out at home.”

A water tanker that is commonly used to transport water to residential areas around Kisumu.

It’s not just poor residents who have a rough time getting good water. Another resident, Didi Otieno, lives in the affluent Milimani Estate in a wealthy part of Kisumu, but she also has a water problem.

“Our part of the estate is not served by piped water,” she says. “I have the means to pay, but the infrastructure does not exist. I usually order around two tankers every month to deliver 10 000 litres of water to my underground tank in my compound. From there, I pump it to the whole house for use.”

Otieno’s home also is not connected to a sewer system, so she installed a septic tank to handle the wastewater. If there were sewage and water treatment plants in the area, she and her neighbours would be more than willing to pay for those services, she says.

Critical international work

The Kisumu County government has been trying to help people like Atieno and Otieno. The goal is for all residents to have clean, piped water. There has been significant improvement compared to a few years ago, but a lot more needs to be done.

The main challenges are from old and dilapidated pumps, and water treatment facilities that are not working properly. There are many leaky pipes. There is no sewer network sufficient to collect the waste water into the existing treatment plants. The result is raw sewage entering Lake Victoria. This hurts the water quality, because the lake is the main source of water for the city.

The European Investment Bank funding and assistance from other international organisations are critical to this work, said Chrispine Juma, the former acting head of the Lake Victoria South Water Works Development Agency, which oversees the project. It has become increasingly hard to attract investors in the water sector in Kenya as the returns are not attractive, he said.

Cutting Lake Victoria pollution

The Kisumu project will improve water treatment facilities and piping for the area, as well as adding a third wastewater treatment plant and installing sewer networks to connect households to proper sanitation pipes, thus reducing the pollution of Lake Victoria, Africa’s largest freshwater lake.

The first phase of the project is nearing completion in 2024, and residents have started reaping some benefits. Water provision and coverage has improved from 26% to 60%. The goal is 90%, when the project is done. Only 8% of the population was previously connected to a sewer network. That’s expected to grow to 40%. More than 1 700 sewer connections will be installed to help serve around 600 000 residents of Kisumu. In the informal settlements, the percentage of homes with access to clean water is expected to grow to 70%.

The European Investment Bank, as one of the largest global investors in water and wastewater treatment, is investing in similar water projects around the world. Over the last decade, the EU’s financing arm provided more than €33 billion for over 300 water projects.

“Here in Africa, the EIB has provided nearly €2 billion to water and wastewater treatment projects over the last decade in loans and grants,” says Caroline Ogutu, a water engineer in the European Investments Bank’s regional office in Nairobi. “Experience gained from involvement in water projects across the continent has strengthened the EIB’s technical support for this project.“

Jan-Willem Lohr, left, and Caroline Ogutu of the European Investment Bank visiting a sewer project in Kisumu, Kenya, with Paul Agwanda of Lake Victoria South Water Works Development Agency, right.

Clean water at subsidised cost

Before the water projects began, Atieno didn’t have a lot of time to play or relax after school. She would start her homework soon after getting home. Around 10 p.m., she would go to sleep. But today, Atieno has more time to live like any other child, playing with friends after school and doing homework early so that she can get enough sleep. Her area now has a lot of water vendors who are providing bulk supplies at fair prices, with support from the local government. Many parts of the settlements have piped water, too.

“Our area now has clean piped water provided to us at subsidized costs,” Atieno says. “This has meant that we no longer have to worry about water diseases, as the water we use is treated. The water is also affordable and we don’t have to ration it. Moreover, my mother and I now have more free time.”

Atieno looks forward to the completion of the project, which will mean even more water and sewer pipes in her area and a supply of water in her house that is available all the time. It will also mean not having to jump or wade through raw sewage flowing along the narrow alleys that she uses to get around the area.

Benefits of water projects

Fixing water problems has a wide range of benefits, says Ogutu, the European Investment Banks water engineer.

“Improving Kisumu’s water system will help its economic growth, too,” she says. “Improved supply will reduce waterborne diseases and healthcare costs, as well as significantly reduce the time spent collecting water, which is usually done by women and children.”

Über den/die Autor/in

Harriet Ongaki

I’m the media officer at the European Investment Bank’s regional hub in Nairobi, Kenya. I write stories that explain how the projects we support transform the lives of people across East Africa.

• infrastructure
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• Health and social care
• Public health
• Health protection
• Antimicrobial resistance (AMR)
• UK 5-year action plan for antimicrobial resistance 2024 to 2029
• Department for Environment Food & Rural Affairs
• Department of Agriculture, Environment and Rural Affairs (Northern Ireland)
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Confronting antimicrobial resistance 2024 to 2029

Updated 8 May 2024

© Crown copyright 2024

This publication is licensed under the terms of the Open Government Licence v3.0 except where otherwise stated. To view this licence, visit nationalarchives.gov.uk/doc/open-government-licence/version/3 or write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: [email protected] .

Where we have identified any third party copyright information you will need to obtain permission from the copyright holders concerned.

This publication is available at https://www.gov.uk/government/publications/uk-5-year-action-plan-for-antimicrobial-resistance-2024-to-2029/confronting-antimicrobial-resistance-2024-to-2029

Executive summary

Antimicrobials are the cornerstone of modern medicine that treat millions of people worldwide. They are used in the treatment of minor and potentially life-threatening infections in humans and animals. They are used in support of surgery and modern cancer therapies. Organisms that become resistant to antimicrobials mean that treatments are less effective, causing harm to humans and animals. Resistant organisms spread through people, animals, food and the environment, creating a major public health threat.

In 2019 the UK published its 20-year vision for antimicrobial resistance ( AMR ). This set the ambitious goal of ensuring AMR will be controlled and contained by 2040. To deliver on this vision, the government committed to producing a series of 5-year national action plans. These will provide sustained and ongoing progress towards achieving the vision’s ambitions for change.

The first 5-year national action plan for antimicrobial resistance , ‘Tackling antimicrobial resistance 2019 to 2024’, was an important step towards achieving this vision. The work carried out across government led to progressive action towards reducing the negative impact of AMR in the UK and globally. Successes of that plan included:

• further reductions in the use of antibiotics in food-producing animals
• the development of improved surveillance systems
• the piloting of new payment schemes for antibiotics on the NHS

This national action plan ( NAP ), ‘Confronting antimicrobial resistance 2024 to 2029’, builds on the achievements and lessons of the first. It contains outcomes and commitments that will make progress towards the 20-year vision for AMR to be contained, controlled and mitigated. To confront AMR , the 2024 to 2029 national action plan has 9 strategic outcomes organised under 4 themes. Action will be taken across all sectors (human health, animal health, agriculture and the environment).

Theme 1 - Reducing the need for, and unintentional exposure to, antimicrobials

This theme has 3 outcomes:

1. Infection prevention and control and infection management - this outcome aims to reduce exposure to antimicrobials through a whole-systems approach to infection prevention and control ( IPC ), improved diagnostics and treatment in different settings (humans, animals, agriculture and the environment).

2. Public engagement and education - this aims to empower and engage the public on the risk of exposure to antimicrobials.

3. Strengthened surveillance - this aims to improve understanding of AMR through capability to measure, predict and understand how resistant microorganisms spread across and between humans, animals, agriculture and the environment.

Theme 2 - Optimising the use of antimicrobials

This theme has 2 outcomes:

4. Antimicrobial stewardship and disposal - this aims to improve the use of antimicrobials to preserve future effectiveness.

5. AMR workforce - this aims to raise awareness with the workforce in human health, animal health and agriculture to improve the optimal use of antimicrobials.

Theme 3 - Investing in innovation, supply and access

6. Innovation and influence - this calls on the life sciences sector to prioritise the development of new approaches to diagnose and treat infections, the development of vaccines to prevent infections as well as the development new antimicrobials.

7. Using information for action - this aims to enable decisions to be based on robust surveillance, scientific research and data sets to provide the best information for decision making. This section also sets out the top research priorities from policy makers.

8. Health disparities and health inequalities - this aims to improve the information available to identify where the burden of AMR is greatest. This will help to target future interventions where they will have the greatest impact.

Theme 4 - Being a good global partner

This theme has the last outcome:

9. AMR diplomacy - confronting AMR is a worldwide problem that requires global action. This outcome aims to fulfil the ambition to have sustained engagement via G7, G20 and other multilateral groups, technical networks, and bilateral relationships that will contribute to worldwide action on AMR .

The themes and outcomes of this plan will move the UK closer to achieving the vision to contain and control AMR by 2040. In taking a One Health approach across people, animals, food and the environment, this NAP aims to preserve the effectiveness of antimicrobials for future generations. The evidence gathered over the next 5 years, including through research, will help strengthen understanding of AMR as a fundamentally important issue and what works to address it.

Figure 1: summary of the 2024 to 2029 NAP

Introduction

The use of antimicrobials underpins modern medicine. Without effective antibiotics, even minor surgery and routine operations could become high-risk procedures if serious infections cannot be treated. Microorganisms which become resistant to antimicrobials, so-called ‘superbugs,’ do not respond or respond less well to available treatments. The emergence and spread of these superbugs affects:

• global public health
• animal health
• food security
• the economy
• sustainable development

The threat of AMR

Antimicrobial resistance is undermining modern medicine.

According to The King’s Fund essay What if antibiotics stopped working? , antimicrobials, particularly antibiotics, save lives and add on average 20 years to life expectancy across the globe. However, bacteria and other microbes can develop resistance to these medicines, which makes treatment much more difficult. This phenomenon, antimicrobial resistance ( AMR ), is a threat across all of medicine and undermines treatments that doctors, vets, their patients and the public have come to rely on.

Effective antimicrobials should be considered as essential infrastructure for a functioning society (see Chandler CIR, Current accounts of antimicrobial resistance: stabilisation, individualisation and antibiotics as infrastructure . Palgrave Communications 5, 53 (2019)). They are not obvious, in the way that other critical infrastructure like roads and railways are, and as such can be taken for granted. Antimicrobials underpin our treatment of infectious diseases. They protect patients with cancer, make childbirth safer, enable safe surgery and support the health and welfare of our animals, including those raised for food. As drug resistance spreads, common infections and injuries that were once easily treatable become harder, and in some cases impossible, to treat.

The rise of AMR

Drug-resistant infections arise when the microbes (including bacteria, fungi, viruses and parasites) that cause them change over time, developing the ability to resist the drugs designed to kill them. This genetic adaptation is driven by the exposure of microbes to antimicrobials in humans, animals and the environment over time. The result of this genetic adaptation is that many antimicrobial medicines - like antibiotics - are becoming less effective at treating certain infectious illnesses.

AMR is a natural phenomenon and a consequence of rapid evolution. It cannot be entirely prevented, therefore the focus is on containing, controlling and mitigating it, as set out in the UK 20-year vision for antimicrobial resistance (that by 2040 AMR is effectively contained, controlled and mitigated).

In Alexander Fleming’s 1945 Nobel Lecture , he delivered a prescient warning about the development of resistance:

It is not difficult to make microbes resistant to penicillin in the laboratory by exposing them to concentrations not sufficient to kill them, and the same thing has occasionally happened in the body.

While AMR occurs naturally, it is accelerated when microbes are exposed to antimicrobials and certain other ‘resistance-driving’ chemicals such as pesticides and heavy metals. When AMR emerges the resistance genes can spread between microbes. Resistant microbes can spread between humans, animals and through our shared environment, impacting the health of humans and animals. For that reason, AMR is a One Health issue, requiring action across sectors. 

AMR affects us all

People are already dying from drug-resistant infections and unless we act now, these deaths will continue to rapidly increase. It is estimated that in 2019, 1.27 million deaths globally were caused by infections resistant to antibiotics (see the Antimicrobial Resistance Collaborators, Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis . The Lancet 399, 10325, pages 629 to 655 (2022)). Much like the coronavirus (COVID-19) pandemic, AMR affects people in all parts of the world; infectious diseases do not respect national borders. Due to the easy spread of resistance, no one is safe until we all are.

We are all at risk of infections from drug-resistant bacteria. According to the UK country briefing from the Institute for Health Metrics and Evaluation ( IHME ), there were an estimated 7,600 deaths directly from infections resistant to antibiotics in 2019, similar to the number of deaths in the UK due to stomach cancer, as well as 35,200 deaths as an indirect result of infections resistant to antibiotics.

Figure 2 below shows the impact of infection and AMR in the UK. The chart shows that in the UK in 2019 there were 87,500 deaths which involved bacterial infection and the number of deaths from other underlying causes of death in the UK in 2019 were:

• self-harm - 5,620
• breast cancer - 15,300
• Alzheimer’s disease and other dementias - 32,400
• lower respiratory infections - 41,900
• tracheal, bronchus and lung cancer - 42,800
• chronic obstructive pulmonary disease - 43,900
• stroke - 50,600
• ischemic heart disease - 93,400

This data is intended to illustrate the large burden of infection in the UK but a direct comparison cannot be made between the deaths which involved bacterial infection and the other underlying causes of death. This is because some of the deaths for non-communicable diseases (such as cancer) could have involved infection. For example, an individual whose underlying cause of death was breast cancer might have died with an infection.

Figure 2: impact of infection and AMR in the UK

Source: IHME Global Burden of Disease (GBD) Study 2019 .

People in the UK are directly affected by drug resistance every single day. AMR is already causing people to suffer longer infections which are difficult to treat. If AMR continues to spread, some infectious diseases, which in the UK would normally be simple to treat with an antibiotic, may become significant new causes of illness and death.

Case study: personal experience

The following is an excerpt taken from a digital story on YouTube told by Laila Hudson about her experience of getting an antibiotic resistant infection while undergoing treatment for bowel cancer.

A sharp pain in my abdomen tore me abruptly from my sleep. I knew immediately something was seriously wrong. This was not the first time we had rushed to the hospital in the dead of the night. Toxic chemotherapy drugs destroyed not just cancer cells but healthy cells too, giving rise to terrifying complications. My bowel had perforated, made weak from the powerful drugs that were supposed to be keeping me alive, allowing bacteria to flood into my abdomen through my blood and around my body. My immune system was fragile from the chemotherapy, meaning I’d had multiple courses of lifesaving antibiotics over the course of my cancer treatment. But this time was different, they didn’t work. My infection was resistant to treatment. Life threatening sepsis set in. My temperature soared, my blood pressure plummeted, and my heart pounded frantically in my chest as it pumped the infection through my veins. The surgeon’s face was grave. Terror gripped every atom of my being. The realisation that I might not wake up from this operation gripped me with an icy shock. I awoke in the intensive care unit. Bone chilling fevers continued to plague me. While the source of infection had been surgically removed, it would take time for the microbiologists to identify an antibiotic that would work to fully clear my infection. The doctors offered little reassurance, reminding me that my bacteria was highly resistant, that if the infection came back they might not be able to treat it. Until then, I thought it was the cancer that would kill me. Now I wondered whether a resistant infection might be a more imminent threat.

Laila’s story: the false peak

Building on the successes of the first national action plan, the core of this plan to tackle AMR is the need to protect patients, the public and the NHS. According to the Organisation for Economic Co-operation and Development ( OECD ) health policy study on Embracing a One Health framework to fight antimicrobial resistance , patients who develop resistant infections are more likely to develop complications and on average spend more time in hospital. AMR increases morbidity and mortality from infectious diseases, it places a demand on the finite resources of the health and care system, therefore impacts the whole of the NHS. Effective antimicrobials also underpin food security, animal welfare and the economy at large.

According to the above OECD health policy study, if we fail to take sufficient action, the costs associated with treating resistant infections could compare to having a COVID-19 pandemic every 5 years.

Our efforts to tackle AMR complement other efforts to improve health outcomes, as set out in the World Health Organization’s people centred approach to addressing AMR .

The UK response

Amr leadership.

AMR is a complex problem, but we can do something about it. This NAP sets out the actions that will be taken across the UK over the next 5 years to confront AMR . This NAP marks the next step towards achieving the UK’s 20-year vision of a world in which AMR is contained, controlled and mitigated.

The next 5 years represent a pivotal period in addressing the global threat of AMR . In a world recovering from the profound impact of the COVID-19 pandemic, international collaboration and preparedness for global health challenges have taken on an unprecedented importance. From 2024 to 2029, the UK is committed to playing a central role in the global effort to confront AMR by taking a comprehensive approach that leverages the UK expertise and domestic experience.

The COVID-19 pandemic underscored the critical importance of global co-operation in tackling biological threats. It showed that a co-ordinated, multilateral approach is essential to effectively respond to emerging global health crises. AMR poses a similar, or perhaps greater threat, and thus requires collaborative working with international partners to address this challenge. The interconnected nature of AMR demands collective action, as no nation or sector can address AMR in isolation.

UK progress to date

The UK was one of the first countries to establish a national action plan on AMR . Since then, extensive progress has been made in raising the profile of AMR and directing resources to tackle it. Since 2013, the UK has taken a One Health approach to tackling AMR , established with the publication of the 2013 to 2018 AMR strategy .

In January 2019, the UK published the vision for AMR to be contained and controlled by 2040. The vision recognises that a global problem as significant and complex as AMR requires long-term action, which must strengthen understanding of AMR itself and understanding of the measures that work best to control it.

To deliver the vision, the UK committed to develop a series of 5-year national action plans. The successes of the first national action plan include activity in all 9 ambitions. This NAP builds on these successes and marks the second in the series of 5-year national action plans.

The first national action plan

The first 5-year national action plan for antimicrobial resistance built a secure basis for the change required to fulfil the 20-year vision for AMR , with particular strengths in policy design, implementation, monitoring and evaluation (see Patel J and others, Measuring the global response to antimicrobial resistance, 2020 to 2021: a systematic governance analysis of 114 countries . The Lancet Infectious Diseases 23, 6, pages 706 to 718 (2023)). The first NAP took a broad approach that facilitated delivery of a wide programme of work to tackle AMR and strengthen health security in the UK and globally.

Notable achievements have included:

• reducing human exposure to antimicrobials by more than 8% since 2014 (despite the pandemic and an outbreak of group A streptococcus)
• piloting novel and innovative ways of evaluating and paying for antibiotics by the NHS
• publishing national IPC manuals in England and Wales (adapted from the Scottish IPC manual)
• publishing the Infection prevention workforce: strategic plan 2022 to 2024 in Scotland
• implementation of aseptic non-touch technique (ANTT) across healthcare services in Wales
• development of the antimicrobial data library portal to provide antimicrobial usage and resistance data for the NHS in Wales - primary and secondary care
• advocating for more action on AMR on the global stage, including through the UK’s G7 presidency where commitments to tackle AMR were secured in communiques from health ministers, finance ministers and environment ministers
• reducing the sales of highest priority critically important antibiotics ( HP-CIAs ) in food-producing animals by 81% between 2014 (3.9 tonnes) and 2022 (0.91 tonnes)
• further reducing the use of antibiotics in food-producing animals (59% reduction between 2014 and 2022)
• investing £19.2 million in One Health surveillance through the Food Standards Agency Pathogen Surveillance in Agriculture, Food and Environment Programme ( PATH-SAFE )

Lessons learnt

Evaluation of the first national action plan.

The national action plan published in 2019 was the first in a series of action plans intended to achieve the 20-year vision for AMR . To inform future policy the Department of Health and Social Care ( DHSC ) commissioned an evaluation of the first NAP , which was led by the National Institute for Health and Care Research ( NIHR ) Policy Innovation and Evaluation Research Unit ( PIRU ) at the London School of Hygiene and Tropical Medicine (LSHTM). See further detail about the evaluation and its findings on the PIRU website .

PIRU focused on aspects of the NAP where evaluation may assist with identifying opportunities for improvement of implementation of AMR policy.

In summary, PIRU ’s evaluation found that:

• there have been a variety of AMR -related policy initiatives in the UK, but without formal prioritisation
• environmental health and diagnostics are areas where there are opportunities for big policy wins to address AMR
• other countries, including Sweden, the Netherlands and Canada, have chosen different policy directions, especially in water industry regulation, antimicrobial use, stewardship and diagnostic implementation. With suitable understanding of each system’s context, the UK can learn some implementation lessons from these policy comparisons
• the UK water industry has the opportunity to play a meaningful role in addressing AMR
• the UK’s human health data systems are positively regarded internationally, but veterinary health and One Health data systems, and data linkage, lag behind
• improved data to inform AMR policy development is needed, including on appropriate prescribing, the contribution of the food chain to AMR rates, and environmental monitoring data

(The above data is also from Glover and others, ‘Evaluation of the 2019 to 2024 national action plan’, an unpublished draft report, not yet peer reviewed.)

Progress has been made in the past decade, since the publication of the UK’s 2013 to 2018 AMR strategy, and in the delivery of the 2019 to 2024 NAP . However, there are areas to tackle AMR where progress has been slow or where there is a need to apply more focus.

In some areas, slow progress has been due to a lack of evidence about ‘what works’. Some of the challenging issues affecting the delivery of healthcare can be difficult to solve (for example, a lack of evidence about the most effective interventions to reduce the incidence of Gram-negative bloodstream infections and by extension the AMR burden associated with these infections). In some areas, focus on and resources allocated to AMR have been insufficient to shift the dial, reflecting its status as an ‘ignored pandemic’. This was compounded when, from 2020 onwards, extensive effort and resource was (appropriately) diverted to the COVID-19 response. The COVID-19 pandemic has reinforced the cross-societal impacts of the spread of infectious diseases and highlighted that urgent action needs to be taken.

Due to the long-term nature of the issue, and the fact that AMR occurs across a variety of pathogens, it has proven difficult to ‘raise the alarm’ in the way seen during the COVID-19 pandemic, where a single pathogen was causing an acute threat to health security.

Lessons learnt from COVID-19

In December 2022, the UK Chief Medical Officers, government Chief Scientific Advisers, national medical directors and public health leaders authored a technical report on the COVID-19 pandemic in the UK , which includes 4 broad reflections throughout the report:

• There were multiple strands of scientific work from different disciplines needed, and these had to be integrated at considerable speed.
• The UK was relatively effective and rapid at responding in areas in which we already had strengths and substantial capacity, including in science and innovation, which could be adapted and built on.
• Science and medicine are international and pandemics by definition cross borders.
• The engagement of policy makers and the public in the scientific insights was profound and critical to the response.

In December 2021, the Academy of Medical Sciences’ FORUM, DHSC and NIHR held a workshop on lessons for AMR that could be learned from the response to the COVID-19 pandemic (see the report from the Academy of Medical Sciences, Antimicrobial resistance research: learning lessons from the COVID-19 pandemic ). Figure 3 shows some notable themes from the discussion. These themes are:

• repurposing of COVID-19 testing infrastructure
• engagement with industry
• regulatory pathways
• technical innovations and public adoptions
• end to end focus with multi-stakeholder engagement
• innovations in regulatory practice
• analysis of real-world and pragmatic trial data
• innovations in vaccine technology

Figure 3: notable themes from the learning lessons from the COVID-19 pandemic workshop

Like COVID-19, AMR is a public health challenge that requires urgent action and could, in time, have an impact far in excess of that of COVID-19. The unprecedented response to COVID-19 - including international focus, political commitment and public engagement - can and should be learnt from to tackle AMR .

About this national action plan

Underlying principles.

In developing this NAP , consideration has been given to the need to take a collaborative approach across the UK, maintain our One Health response, be a good global partner, reduce inequalities and maintain resilience. These principles are explained in the following pages.

Taking a collaborative approach across the UK

Co-ordinated action between England, Northern Ireland, Scotland and Wales, and across sectors is necessary to tackle AMR . Working together is prioritised because:

• there is a shared vision to contain and control AMR
• pathogens do not respect borders
• there are similar challenges in each part of the UK, and opportunities to learn from one another

Collaboration is facilitated through formal mechanisms such as the Common Framework on Health Protection and Health Security as well as through AMR -specific structures.

Taking a One Health approach

According to the World Health Organization ( WHO ), One Health is an integrated, unifying approach that aims to sustainably balance and optimise the health of humans, animals, plants and ecosystems. It recognises the close links between the health of humans, domestic and wild animals, plants and the wider environment (including ecosystems).

The approach mobilises multiple sectors, disciplines and communities at varying levels of society to work together to foster wellbeing and tackle threats to health and ecosystems, while addressing the collective need for clean water, energy and air, safe and nutritious food, taking action on climate change and contributing to sustainable development.

Drug-resistant microbes can be found in people, animals, food and in the environment. Through contact with other people, animals and the environment, these microbes and resistance mechanisms can be transferred between and among different species, affecting the health of people and animals, including companion animals, food-producing animals, and wildlife. It is vital to take an approach which recognises this interconnectivity. According to the UN Environment Programme ( UNEP ), a One Health approach means working collaboratively and inclusively across sectors to improve outcomes for humans, animals and the environment.

In this NAP , when referring to working across ‘all sectors’, this includes human health and social care, animal health, agriculture, food production and the environment. Unless otherwise specified, activity in this document should be assumed to cut across several or all of these sectors.

Figure 4 illustrates the interactions which allow for the spread of resistance, demonstrating the need for a One Health approach to  AMR . These interactions are between:

• humans (including in hospitals and GPs , care homes and the community)
• animals (including food animals, companion animals and wildlife)
• the environment (including water, crops and land)

It shows that the spread of resistance is facilitated through direct contact between:

• humans and the environment
• humans and animals
• animals and the environment

It also shows that resistance can spread through food when:

• food animals are eaten by humans
• food animals are eaten by companion animals
• crops are eaten by humans
• crops are eaten by animals

It also shows that resistance can spread through waste when:

• human waste is released into the environment
• animal waste is released into the environment

Figure 4: the need for a One Health approach to AMR

Being a good global partner

The UK has an established history as an international leader in tackling AMR . The UK is dedicated to working with partners across the globe to ensure the efficacy of antimicrobials now and for generations to come by drawing on UK expertise, including in the life sciences sector, and the sharing of best practice to strengthen global capacity to tackle AMR . Actions to reduce AMR also tie in with other health and development goals, including the sustainable development goals ( SDGs ).

The UK will continue to work with international partners to galvanise global action on AMR , particularly through groups such as the G7 and G20 and with multilateral organisations including UN organisations. Further information on our global commitments over the next 5 years can be found in the ‘Outcome 9 - AMR diplomacy’ section.

The UK recognises the importance of working with, and building capacity in, low and middle income countries ( LMICs ) to tackle AMR . Through UK aid investments, the UK will continue to assist countries in implementing effective strategies to address AMR within their health and care, agricultural and environmental sectors. This aligns with the global commitment to equity and ensuring that all nations have the tools and resources necessary to tackle AMR . Our investments will include supporting early-stage priority research and innovation in underfunded areas via the Global AMR Innovation Fund ( GAMRIF ) and strengthening surveillance systems through the Fleming Fund.

Reducing inequalities

AMR impacts groups differently and the interventions required to meaningfully tackle AMR must therefore be tailored to different groups, settings and circumstances. Efforts to tackle health disparities and health inequalities are recognised for the first time in this NAP , with a specific outcome (outcome 8) focused on better understanding and addressing disparities in tackling AMR .

Just as AMR affects different groups within the UK differently, so too are its impacts unequally spread globally. There are patients in many parts of the world who cannot access the antibiotics and other antimicrobials they need. According to the Access to Medicine Foundation’s 2021 antimicrobial resistance benchmark , 5.7 million people die annually from treatable infections because of this lack of access to medicines. This is sometimes described as an access or excess trade-off. Lack of access to appropriate antimicrobials and fragile supply chains force the use of suboptimal treatments, giving pathogens further opportunities to develop resistance and thereby stoking the rise of resistant infections. Improving access to treatments, as well as strengthening IPC programmes, will save lives and prevent resistance arising and spreading.

The UK will continue to invest in tackling AMR where it is most impactful and ensure that our actions to address AMR to reduce the burden for the people who are more affected.

Resilience to a changing threat landscape

AMR is recognised as a key biological risk in the 2023 UK Biological Security Strategy ( BSS ). The BSS sets out the vision that by 2030, the UK is resilient to a spectrum of biological threats, including AMR . AMR is also captured as a chronic risk in the UK National Risk Register . The UK government’s wider Resilience Framework sets out an approach to strengthen the systems that provide resilience to risk, by focusing on a shared understanding of risks, preparation and prevention, and a whole of society approach.

AMR and pandemic preparedness are interconnected challenges that require a holistic approach at the local, national and international level. For example, the public health impacts of a pandemic might be worsened without access to effective antibiotics. Conversely, AMR might be accelerated if antibiotics are used indiscriminately to tackle a pathogen that is not well characterised. Efforts to tackle AMR , including the responsible use of antimicrobials and implementing effective IPC measures, as well as learning from COVID-19, will strengthen preparedness for the next pandemic. Tackling AMR should be integrated into efforts to prepare for future pandemics, including embedding a One Health approach in development of any WHO instrument on pandemic preparedness.

Climate change is widespread, rapid and intensifying. Many infectious diseases are climate sensitive, and climate change and AMR are linked emergencies. They are both One Health, global issues with the highest burden falling on LMICs .

Case study: AMR and climate change

There is evidence that climate change might worsen the impacts of AMR . The climate is an important driver of patterns of infections, year-to-year variations in incidence (including epidemics) and longer-term shifts in populations at risk.

Rising temperatures, water shortages, extreme weather and loss of biodiversity resulting from climate change might all change the dynamics of the spread of infections and our ability to prevent them.

The mitigation of both climate change and AMR requires:

• capacity building for local mitigation and adaption
• generation and dissemination of data
• public-private partnerships for new technologies and practices
• implementation research
• increased institutional commitment and co-ordination, and alignment of strategies

Development and delivery process

This 5-year NAP , outlined in the following chapters, builds on the UK response to date and the lessons learnt from evaluation of the first NAP , experiences during the COVID-19 pandemic and best practice from international leaders. Further information on the development process and the theory of change can be found in ‘Appendix A: NAP development’.

To confront AMR this NAP has 9 strategic outcomes, underpinned by 30 commitments that set out the activity that government organisations will undertake to achieve the outcomes. The outcomes and commitments were informed by extensive stakeholder engagement. Each of the commitments starts ‘we will’ - ‘we’ refers to government organisations (including departments and arm’s length bodies) and the NHS in England, Scotland, Wales and Northern Ireland.

AMR is a broad issue, encompassing resistance developed by a wide range of microorganisms, including bacteria, viruses, parasites and fungi. In line with the Interagency Coordination Group on Antimicrobial Resistance ( IACG ) framework for action, this NAP incorporates action to address resistance in all of these pathogenic domains. The focus will be on resistance to antibacterials (antibiotics), which poses the greatest, immediate risk to public health.

In addition to government activity, the active participation of public and private sector bodies across the human health, animal health and environment communities will be required to achieve the 9 outcomes. The support of the public as patients, consumers, animal owners and investors will also be important in achieving the outcomes.

The following chapters take each of the 9 strategic outcomes in turn, outlining the commitments underpinning each outcome and the rationale for each of them. Progress in delivering the national action plan will be determined based on the delivery of these commitments.

Outcome 1 - Infection prevention and control and infection management

By 2029, the UK takes a whole-systems approach to IPC and infection management in all sectors by reducing unnecessary exposure to antimicrobials and preventing infections, including identification, assessment, diagnosis and treatment of infections in an integrated way across different settings.

This outcome has:

• informed interventions
• the built environment
• waste minimisation and effective waste management
• target 1a: by 2029, we aim to prevent any increase in a specified set of drug-resistant infections in humans from the 2019 to 2020 financial year baseline
• target 1b: by 2029, we aim to prevent any increase in Gram-negative bloodstream infections in humans from the 2019 to 2020 financial year baseline

Tackling AMR requires a focus on preventing infection in humans and animals, therefore IPC is a core element of this NAP . Reducing the burden of infection in the human population by optimising IPC measures also improves patient safety. Prevention and control of infection in humans and animals means less use of antimicrobials and thus lower risk of resistance developing and reduced onward spread. When infection has not been prevented and needs treatment, ensuring the right antimicrobial is prescribed (and taken as prescribed) is crucial to minimising risk of resistance.

Bacteria and other organisms know no borders, as the COVID-19 pandemic demonstrated. Action to reduce infection burden to reduce risk of AMR must take place in both national and international contexts, aligning with organisations and plans such as the WHO EURO Roadmap 2023 to 2030 .

As also demonstrated during the COVID-19 pandemic, one of the main measures by which infections can be reduced both in number and severity is through vaccines. Vaccines can reduce the need for antimicrobial treatment and therefore minimise the selection pressures which cause antimicrobial-resistant strains to emerge. As vaccines not only protect the individual person or animal who has been immunised, but the whole community of which they are part, ensuring good and equitable immunisation rates within the UK, as well as working with international partners to improve coverage worldwide, is a fundamental part of our efforts to reduce AMR .

In the UK, there has been work over many years in animal agriculture to reduce endemic disease, with vaccination programmes playing a vital role in disease control. Initiatives such as the Department for the Environment and Rural Affairs’ ( Defra ) Animal Health and Welfare Pathway, support continual improvement by collaborating with farmers, vets, industry and the supply chain to deliver benefits for animal health and welfare, farm productivity, food security, trade and the environment.

Commitment 1.1 - Informed interventions

We will continue to improve IPC and biosecurity practices that are informed by the latest evidence base and social sciences to minimise the potential for infection transmission, including outbreaks, optimise the management of infections and reduce the need for antimicrobial exposure.

Applies to people and animals.

IPC is a practical, evidence-based approach to prevent harm from otherwise avoidable infections. It includes a variety of different measures, from handwashing to design and build of environments. IPC interventions must be informed by research and evidence, including surveillance, to inform tailored action against specific patterns of infection and resistance, ensuring efforts are maximised and have the highest impact. There is variation in the infections responsible for the biggest burden of disease in different parts of the UK, and IPC measures can and should be tailored to respond to the different contexts. In addition to ongoing monitoring, the UK Health Security Agency ( UKHSA ), National Services Scotland, Public Health Wales and the Public Health Agency (Northern Ireland) each publish surveillance reports which help identify trends and any areas of concern, which can then be addressed in the local context:

• English surveillance programme for antimicrobial utilisation and resistance ( ESPAUR ) report
• Scottish One Health antimicrobial use and antimicrobial resistance in 2021
• Welsh antimicrobial resistance and prescribing surveillance and reports
• surveillance of antimicrobial use and resistance in Northern Ireland, annual reports

For human populations, the health system can influence the emergence and spread of AMR through reliably applying measures to prevent and control infection and, when infection occurs, responding and managing these with evidence-based care pathways that support the appropriate (and timely) usage of antimicrobials in every day clinical care.

In veterinary and farm settings, ‘biosecurity’ is used to describe the application of IPC principles. Biosecurity focuses on measures which reduce the risk of disease entering and spreading in settings such as farms or veterinary practices. Good hygiene and husbandry practices are also required to mitigate the risk of disease spreading from animals to their keepers.

Research, evaluation and analysis of current practices, environmental factors, and human behavioural factors can inform which IPC interventions work best and where further work is needed, in human and animal healthcare, community, social care and farm settings. A good programme of informed interventions involves training of medical and veterinary healthcare professionals, as well as education of patients and animal keepers.

Commitment 1.2 - The built environment

We will prioritise IPC , the management of infections and biosecurity in the built environment, ensuring an understanding of AMR is integrated into health and social care estate design, veterinary practices and farm settings.

Applies to people, animals and the environment.

It is important that the design of health and care facilities, veterinary facilities, farm buildings and abattoirs facilitates good IPC practices and that the quality and design of finishes and fittings enable thorough access, cleaning and maintenance to take place.

For the human population, the healthcare environment can be a reservoir for organisms with the potential for infecting patients. For healthcare associated infections ( HCAIs ) to be reduced, it is imperative that IPC measures are ‘designed-in’ at the outset of the planning and design stages of a healthcare facility and that input continues up to, into and beyond the final building stage.

Designed-in IPC for healthcare facilities means that designers, architects, engineers, facilities managers and planners work with IPC teams, other healthcare staff, patients and visitors to deliver facilities in which IPC needs have been anticipated, planned for and met. Similarly, when older facilities are renovated or rebuilt, there is the opportunity to implement modern IPC measures and improve design.

These design considerations are also essential for veterinary facilities, where HCAIs , including MRSA , have been documented (see Weese JS and van Duijkeren E, Methicillin-resistant Staphylococcus aureus and Staphylococcus pseudintermedius in veterinary medicine . Veterinary Microbiology, 27, 140, pages 418 to 429 (2010)). Evidence-based IPC programmes should be implemented in every veterinary practice, hospital and small clinic to protect the health of animals, owners, and vet professionals.

In farm settings, careful consideration is needed to ensure the farm environment enables good husbandry, biosecurity and biocontainment measures to take place. Considerations such as the location of the farm relative to the community, structure and layout of the farm and procedural biosecurity should be included in farm development and/or design.

Commitment 1.3 - Waste minimisation and effective waste management

We will implement effective waste management, wastewater treatment methods and agrochemical stewardship to minimise dissemination of AMR and AMR -driving chemicals into the environment.

Applies to the environment and plants.

Addressing AMR in the environment is essential to reducing preventable, unintentional exposure to antimicrobials and to slowing the emergence and dissemination of resistance. The UNEP 2023 report, Bracing for superbugs: strengthening environmental action in the One Health response to antimicrobial resistance outlines 3 notable environmental dimensions of AMR :

• development of AMR in the environment: antimicrobials affect microbes in the environment just as they do in the body. These environmental microbes can develop resistance if they are exposed to antimicrobials, or other AMR -driving chemicals
• AMR and the triple planetary crisis: AMR shares drivers with the main environmental issues of this century - climate change, biodiversity loss and pollution and waste
• AMR transmission and spread in the environment: AMR can spread between humans, animals and the environment by a variety of pathways, including recreational use of bathing waters (such as swimming or surfing) and consumption of food or untreated water

Poor waste management and water treatment can lead to the transmission of drug resistant microbes from humans, animals and plants into the shared environment. In order to reduce AMR spread into the environment, stewardship initiatives to reduce pollution from hospital and community wastewater, agricultural activities and antimicrobial manufacturing need to be developed and implemented.

Attention is increasingly turning to water quality and the relationship between the environment and public health, and the environment and animal health. The PIRU evaluation of the first NAP found that co-ordination across the governments of the UK and with the academic community and the water industry could be improved.

Several initiatives across the UK are in place to ensure that citizens know that the water from their taps is safe to drink and that their sewage waste is properly managed and treated. This includes regulation of water companies and monitoring of waterways, and so regulators and water companies will play a vital role in this area. While these interventions are not all specific to AMR , they will help mitigate resistance.

Examples of recent interventions that have been developed or implemented include:

• setting new legally binding targets to significantly reduce pollution from farming, wastewater and abandoned metal mines (England)
• increasing monitoring of storm overflows from only 10% in 2015, to over 90% (England)
• establishing the Antibiotics and Pharmaceuticals Monitoring Programme to identify sources of AMR driving chemicals in the environment (Northern Ireland)
• testing for antibiotic resistance in bacteria at bathing water sites and producing a publicly accessible visualisation tool to present the data (Scotland)
• researching AMR genes and AMR driving chemicals in wastewater and sludge at different types of wastewater treatment plants through the UK Chemical Investigations Programme (England)
• development of pilot AMR surveillance in river catchments through PATH-SAFE

Initiatives to support responsible agrochemical stewardship will also mitigate AMR . Pesticides, including fungicides, play an important role in supporting crop production and food supply. However, antifungal resistance in humans, which is in part driven by the use of fungicides, is increasing globally (see Fisher and MC and Denning DW, The WHO fungal priority pathogens list as a game-changer . Nature Reviews Microbiology, 21, pages 211 to 212 (2023)) and in the UK. Fungicides must be used responsibly to reduce potential risk to public, environmental, or animal health. Antifungal resistance is being driven by antifungal use in crop protection products and fungal spores can be transmitted as airborne particles.

We are committed to minimising the risks and impacts of pesticides to human health and the environment, while ensuring pests and pesticide resistance are managed effectively, including through the uptake of integrated pest management and sustainable crop protection, in line with Defra ’s 25 year environment plan, the Welsh Minister’s natural resources policy, the environment strategy for Scotland, and the goals of the environment strategy for Northern Ireland to protect and enhance the environment for future generations.

Outcome 2 - Public engagement and education

By 2029, the public are empowered and equipped to engage on and help address AMR through an improved understanding of the scale and nature of the risk, and the individual behavioural actions that can be taken to address it.

• public awareness and campaigns
• use of educational settings
• engagement guide
• human health target 2a (see appendix B): by 2029, we aim to increase UK public and healthcare professionals’ knowledge on  AMR  by 10%, using 2018 and 2019 baselines, respectively

A collaborative approach is needed to solve AMR , with action taken by governments being only one part of the solution. Action is also required from professionals and professional bodies, patients or service users, the public, consumers and animal owners, the private sector and investors, and the research community and academia. Many people fall into more than one of these groups - a farmer or pharmacist could also be a pet owner and will almost certainly be a patient at some point. Collaborations across sectors will aid the development of targeted strategies, engage the public, and promote sustained behaviour change to effectively prevent AMR .

Stakeholders overwhelmingly called for action to increase public awareness in the call for evidence on AMR . Public engagement is only one component of tackling AMR , which can be influenced at personal and societal levels (see Smith E and Buchan S,  Skewed perception of personal behaviour as a contributor to antibiotic resistance and underestimation of the risks . PLOS ONE, 18, 11 (2023)). Efforts on public engagement will be focused on that which is evidence-based and as effective as possible.

Case study: Fleming Centre

The UK government is investing £5 million of seed funding into the Imperial College London and Imperial Healthcare NHS Trust’s Fleming Initiative. This will make a major contribution to the UK’s vision to contain, control and mitigate AMR , by co-locating diverse expertise and centralising the role of civil society in addressing the crisis. It aims to deliver:

• world class laboratory, clinical and behavioural research to develop, incubate and test innovations against AMR
• a unique space to engage and involve the public in the past, present and future of AMR research, enabling the development of solutions with buy-in from all
• evidence-led advocacy, convening power and policy work to drive impact
• a global network to tackle AMR , by linking with other centres around the world

The centre, a physical space, is intended to open in 2028, the centenary of Alexander Fleming’s discovery of penicillin, on the St Mary’s Hospital site, in Paddington, where he made the discovery.

Commitment 2.1 - Public awareness and campaigns

We will launch and evaluate evidence-based campaigns to raise public awareness and understanding of IPC , infection management, antimicrobial stewardship and AMR , informed by surveys of public attitudes and adjusting content and approach to empower the public and effect sustainable behaviour change.

The threat of AMR can be mitigated, but only with participation from all aspects of society. The evidence base will be developed in order to tailor responses, harness the power of the public, and elicit sustained behaviour change on AMR .

To inform what action is required to engage the public, and effect sustainable behaviour change, understanding of the current public attitude and awareness of issues relating to AMR is required. This will enable targeted activity that can measure the impact of future awareness-raising activity. The call for evidence on AMR found that there is insufficient public awareness of AMR (95% of respondents), with campaigns commonly suggested as a route to increase awareness.

During the COVID-19 pandemic, the public made a meaningful contribution to reducing the spread of infection - see Antimicrobial resistance research: learning lessons from the COVID-19 pandemic from The Academy of Medical Sciences. Self-care can be a powerful tool to empower patients. It should, however, be noted that the PIRU evaluation of the first NAP cautioned against pushing self-care without protecting access to formal health services. The response to AMR needs to be sensitive not just to basic biology, but crucially to human behaviour. We are committed to testing and learning from interventions that help educate and inform the public.

There is a strong track record of public health communication in the UK, but it is critical to continue to adapt to the changing media landscape, including the spread of disinformation.

Case study: Keep Antibiotics Working

The Keep Antibiotics Working ( KAW ) media campaign was a multi-channel social marketing and communications campaign developed in 2017. It focused on increasing awareness within the general public and supporting general practitioners ( GPs ) in prudent antibiotic prescribing. The campaign was subsequently adopted in Scotland, Wales and Northern Ireland.

The campaign messaging aimed to reduce patient expectation for an antibiotic prescription and support confidence of GPs to prescribe appropriately. An evaluation of the KAW campaign showed that campaign recognition increased significantly and achieved a higher level of recognition compared to previous national antibiotic awareness campaigns (see Gilham EL and others, Assessing the impact of a national social marketing campaign for antimicrobial resistance on public awareness, attitudes, and behaviour, and as a supportive tool for healthcare professionals, England, 2017 to 2019 . Eurosurveillance, 28, 47, (2023)). In addition, aspects of participant knowledge, awareness and understanding of AMR increased significantly following the campaign. KAW also supported change among GPs with those who were aware of the campaign reporting greater confidence to say no to most patients asking for antibiotics. GPs who were aware of the campaign were also more likely to explain that prescription of antibiotics for viral infections was inappropriate when asked for antibiotics by a patient.

In 2023, the KAW branding was used in Scotland to promote an ‘antibiotic amnesty’ campaign encouraging people to return unused antibiotics to the pharmacy rather than sharing or keeping antibiotics. This shows the potential for the brand to be adaptable for future campaigns, depending on need.

Commitment 2.2 - Use of educational settings

We will work with schools and educators to consider guidance and information on IPC and AMR for use in all public authority educational settings.

Applies to people.

AMR can, and will, affect us all - we will all experience infections at some point in our lives, hopefully infrequently. Every day we all make choices about infection prevention (including hand washing and food hygiene) and how we manage our own infections - many of us will look after pets, travel abroad, swim in lakes and rivers, and choose how to invest our money.

Responses to the call for evidence on AMR indicated that targeting awareness-raising programmes at school children could build future understanding and support for AMR action. If IPC , infection management and AMR can be meaningfully presented in educational settings, then children may be able to drive change in behaviours. This is especially important as some of those children will grow up to be the next generation of doctors, nurses, other healthcare workers, scientists and professionals. By ensuring that they are aware of, and have an interest in AMR , we will encourage careers in the area, and can look forward to having a workforce where reducing AMR is forefront in everyone’s mind.

AMR should not be siloed and ‘left to the experts’. We plan to empower young people on this issue, which may disproportionately affect them. We need their buy-in to ensure that there are still working antibiotics for future generations.

Case study: e-Bug

There are existing resources used in schools to support IPC efforts and respond to AMR , including e-Bug , operated by UKHSA . This health education programme aims to promote positive behaviour change among children and young people, through provision of free resources for educators, community leaders, parents and caregivers, to ensure they can contribute to preventing infection outbreaks and using antimicrobials appropriately. The resources that e-Bug provides are evidence based and grounded in behaviour change methodology.

 Commitment 2.3 - Engagement guide

We will publish an engagement guide covering communications approaches for AMR , which has been co-created by and for government, civil societies and local partners, to improve public understanding of the risk, and the individual actions they can take to reduce the spread of infections.

AMR affects every aspect of society. Framing of this complex issue is essential, and there is demand for clear, consistent messaging about AMR . Different communities seek their information and health advice from a wide range of sources, including local government, community organisations and local leaders.

An engagement guide focused on AMR would provide resources for use with a variety of stakeholders, to share the most pertinent information and give people the knowledge they need to change their AMR -driving behaviours and minimise their risk of infection to keep themselves and their communities healthy. By taking a collaborative, outward looking approach, we will ensure the guide is not limited to perspectives from government organisations but accurately reflects the needs of, and is accessible to, end users.

This engagement guide will provide materials which support the delivery of the previous 2 commitments on public engagement and education.

Outcome 3 - Strengthened surveillance

By 2029, the UK will have an improved capability to measure, predict, understand and mitigate the evolution and transmission of resistant microorganisms and genes, locally, nationally and internationally and across and between human, animals, agriculture and environmental sectors.

This outcome has 2 commitments:

• optimising surveillance of infections and outbreaks, and response
• optimising surveillance to inform interventions

Surveillance is a vital tool in understanding the extent of and risks associated with AMR . It provides essential data to allow the development of effective interventions and to detect and act on outbreaks. It helps target efforts where they can make the biggest difference and provides the data to inform modelling which can be used to predict the impact of interventions, future trends and the health and economic burden from AMR . Information on infection incidence, antimicrobial usage and AMR provided through surveillance programmes also helps to better understand mechanisms of resistance and, when successfully integrated, improves understanding of the transmission routes of AMR . A central aim of robust surveillance is longevity. Longstanding surveillance programmes allow us to track trends over time, and to evaluate the impact of interventions. Extensive surveillance is undertaken in the UK already, with regular reports published by the Veterinary Medicines Directorate ( VMD ) and the public health agencies in England, Scotland, Wales and Northern Ireland.

Global surveillance databases, such as Global Database for Tracking AMR Country Self- Assessment Survey (TrACSS) , Global Antimicrobial Resistance and Use Surveillance System (GLASS) and Animal Antimicrobial Use (ANIMUSE) facilitate access to a growing set of information and enable member states to benchmark progress. Reviewing data on AMR and antibiotic use can be a motivation for behaviour change from practitioners to policy makers. Access to this information can also help to identify gaps for capacity building and investment. The UK is supportive of the global, collaborative effort to standardise AMR surveillance, in line with the WHO global action plan on AMR .

Surveillance is also a significant enabler of high-quality research into AMR .

The PIRU evaluation of the first NAP found that there had been progress made in harmonisation and integration of surveillance between sectors over the past 5 years, though some gaps remain. Suggestions for ways to strengthen the surveillance systems in the UK included (but were not limited to) extending standardised data collection to the environment, monitoring AMR in the healthy population and facilitating data-sharing agreements.

Case study: PATH-SAFE

The rapid detection, identification and tracking of pathogens has always been fundamental to public health but recent advances in DNA-based methods have massively improved our ability to do this. Modern genome sequencing enables us to identify pathogen and resistance strains rapidly and cheaply and use this to reconstruct chains of transmission and trace outbreaks to their source.

The Pathogen Surveillance in Agriculture, Food and Environment ( PATH-SAFE ) programme, a £19.2 million Shared Outcomes Fund research programme, aimed to pilot the development of a national surveillance network, using the latest DNA-sequencing technology and environmental sampling to improve the detection and tracking of foodborne human pathogens and AMR through the whole agri-food system from farm to fork.

PATH-SAFE has explored the application of advanced genomic technologies to improve control and reduce disease via routes such as:

• source tracking: working back from outbreaks in humans or findings in food to the source of the infection or contamination and thus being able to remove this or mitigate its risk and prevent future outbreaks (‘reactive control’)
• earlier detection: enabling more efficient detection of pathogens at an earlier point in the chain and thus prevent the contamination of food or outbreaks (‘proactive control’)

This pilot project has taken a collaborative One Health approach (integrating human, animal and environmental health), establishing shared technology platforms, common data standards, methodology development and data generation in an innovative and dynamic way. Data interoperability and shared best practice allows for the tracking of pathogens across government departmental boundaries of responsibility and offers major efficiencies in terms of future procurement and resource needs. Involvement of industry and academic stakeholders in the PATH-SAFE programme, alongside government organisations, has strengthened the research undertaken.

The PATH-SAFE pilots have pushed forward the evidence base for AMR in UK livestock populations, generating new representative data on AMR in ruminants, while also trialling new surveillance techniques and approaches. PATH-SAFE has demonstrated what can be achieved in the One Health space with dedicated resource for co-ordination and cross-departmental funding.

Commitment 3.1 - Optimising surveillance of infections and outbreaks, and response

We will optimise surveillance processes through effective, standardised and integrated (where possible) systems to detect, track and model infections and outbreaks or incidents, to monitor antimicrobial usage (including quality of prescribing) and susceptibility, and to facilitate cross-organisational responses to mitigate risks to patients and the public.

It is crucial to review and, when needed, improve, surveillance processes to better detect and respond to outbreaks early and effectively. Improving data sharing across organisational boundaries and ensuring standardisation of information will improve our capability to understand and respond to infections, including resistant infections.

In the human population, the NHS will aim to measure the quality (in addition to quantity) of prescribing. This will enable clinicians to take a more nuanced approach, rather than solely focusing on the number of prescriptions issued. The nature of antimicrobial prescribing is changing with increasing numbers of non-medical prescribers, greater utilisation of patient group directions in hospitals and the community, and a shift from face-to-face prescribing to virtual and online prescribing. A better understanding of who (and how) antimicrobials are prescribed to is vital.

Poor quality coding currently hampers efforts to evaluate quality of prescribing and there is room for improvement. Therefore, the work to incentivise digital coding of diagnosis (set out in commitment 4.1), lays the vital foundation for quality improvement as well as providing intelligence on the ever-shifting burden of disease and disease severity that determines clinical need for antimicrobials.

In animal health, all antibiotics must be prescribed by a veterinarian. As use of antibiotics in animals continues to reduce, surveillance will improve understanding of other drivers of AMR through humans, animals and the environment. This can only be achieved through integrated One Health surveillance where data is shared between sectors, and a collaborative approach to mitigate the spread is taken. This work was advanced by the PATH-SAFE programme, with future progress expected through the BSS National Biosurveillance Network initiative.

Case study: Zambia One Health surveillance platform

DHSC ’s Global AMR Innovation Fund ( GAMRIF ) partnered with the global health non-profit Foundation for Innovation New Diagnostics to work with the Zambia National Public Health Institute and software engineers to launch a One Health surveillance platform for AMR . This new data management system tracks and maps the emergence of resistance, in humans and animals, forming the basis of national surveillance programmes, and enables the Zambian government to make data-driven decisions. The platform ensures burden-free implementation for health workers, no new data silos and long-term sustainability. It is also open source.

Zambia had several established data sources but previously lacked a systematic approach towards the collection and analysis of this data. Furthermore, this new system made it even easier to submit AMR data to the Global Antimicrobial Surveillance System, a WHO initiative. The system improves disease surveillance beyond AMR by identifying and monitoring outbreaks and enhancing clinical care. Following the launch, the platform is now being implemented in other countries in Africa and Asia as part of DHSC ’s Fleming Fund.

Commitment 3.2 - Optimising surveillance to inform interventions

We will enhance technical capacity for surveillance across sectors (and associated analytics and modelling) to inform intervention development, evaluation and application focused on areas of greatest risk, including highest burden of AMR and (where possible) sharing information and lessons to support personnel in all sectors to reduce AMR and its consequences.

One Health integrated surveillance will be used to inform effective interventions across sectors to reduce AMR and its consequences. In order to acquire the best possible data, the aim is to enhance surveillance by utilising techniques such as whole genome sequencing ( WGS ), modelling and analytics. WGS can help improve the depth of data generated from isolates, thereby enhancing routine surveillance, outbreak detection and outbreak response.

Modern sequencing technologies will be routinely used and provide the basis for more informative genomic surveillance of AMR . These modern technologies include metagenomics and those that provide longer sequence reads and therefore more complete information on the mobile genetic elements of AMR transmission. Implementation of the latest analytical techniques for identifying genes and mutations associated with AMR in WGS data will further improve the quality and quantity of data available for surveillance.

When applied in global, national and local AMR surveillance, these tools have the potential to improve understanding to support new policies and interventions, including novel diagnostic methods to support informed antimicrobial use and vaccination strategies for better controlling AMR .

To enable efficient and extensive use of genomic AMR data, the design and implementation of data handling solutions will be explored. The design should accommodate complexities such as AMR outbreaks caused by the same AMR -causing mobile genetic element transferred among different pathogen species, or longer-term trends in AMR epidemiology. These should provide new or use existing open standards, for the handling of AMR -related information, to facilitate working with international partners and allow convenient and effective querying for surveillance and response planning. Few countries offer large scale sequencing and analysis of AMR associated isolates so UK data would provide vital insight into the molecular epidemiology of these infections and position the UK to exploit the knowledge these new methods can provide.

Outcome 4 - Antimicrobial stewardship and disposal

By 2029, the UK has strengthened antimicrobial stewardship and diagnostic stewardship by improved targeting of antimicrobials and diagnostic tools for humans, animals and plants, and improved the disposal of antimicrobials, informed by the right data, risk stratification and guidance.

• clinical decision support
• appropriate prescribing and disposal
• behavioural interventions
• target 4a: by 2029, we aim to reduce total antibiotic use in human populations by 5% from the 2019 baseline
• target 4b: by 2029, we aim to achieve 70% of total use of antibiotics from the Access category (new UK category) across the human healthcare system

While all use of antimicrobials drives AMR , there is an opportunity to reduce inappropriate use of antimicrobials occurring, for example, when antimicrobials are taken when they are not needed, or when taken for longer than necessary.

According to the National Institute for Health and Care Excellence’s NICE guideline (NG15) :

The term ‘antimicrobial stewardship’ is defined as ‘an organisational or healthcare‑system‑wide approach to promoting and monitoring judicious use of antimicrobials to preserve their future effectiveness’.

Antimicrobial stewardship ( AMS ) approaches are employed to manage the use of antimicrobials, preserve their efficacy and minimise the emergence of AMR . Stewardship activities can be undertaken by anyone and should be encouraged by everyone, not just by human and veterinary healthcare professionals but also patients, animal owners, and the public. Similar principles apply for stewardship in people and animals.

In animal health, AMS activities centre around veterinary professionals and animal keepers and the commitments relating to stewardship in animals are therefore found in the ‘Outcome 5 - AMR workforce’ section.

In farming, antifungal use in crops is an emerging issue for AMS . Antifungals and pesticides are used for the benefit of plant health and help support food security. However, they differ to antimicrobials used in human and animal health as they are not prescribed medicines and are applied directly to the environment. According to the UNEP 2023 report, Bracing for superbugs: strengthening environmental action in the One Health response to antimicrobial resistance , fungicide and bactericides use in agriculture has been increasing globally.

There are close links between humans, animals and the environment but reducing the consumption of antibiotics in animals alone will not be sufficient to reduce the burden of AMR in humans. The significant reductions in antimicrobial use in animals provides some benefit to the risk of AMR in people, primarily by reducing foodborne disease but mostly mitigates the AMR threat to animal health. According to the third UK One Health report , most antibiotics in the UK are consumed by people (two-thirds) not animals, and human use drives AMR in bacteria in humans. Stewardship interventions within other settings have a proportionally smaller impact on AMR compared than those made within healthcare settings.

Case study: GAMSAS

Developed by the British Society for Antimicrobial Chemotherapy ( BSAC ) and led by experts in antimicrobial stewardship ( AMS ), the Global Antimicrobial Stewardship Accreditation Scheme ( GAMSAS ) initiative reviews, mentors and accredits hospital AMS programmes through a robust assessment process. GAMSAS aims to establish centres of excellence in the UK and around the world to tackle AMR by supporting the use of effective AMS .

GAMSAS is a quality-improvement focused, points-based accreditation scheme based on standards for AMS and the supporting IPC and microbiology laboratory services. AMS standards have been developed utilising published standards from around the world and reflect what is feasible across both high-income countries and LMICs . GAMSAS strives for a collaborative approach to stewardship globally, raising standards, sharing best practice, and facilitating mentorship between communities.

GAMSAS aims to:

• identify local areas of practice needing improvements and support
• develop regional networks to support the spread of good practice in AMS
• create awareness in healthcare payers and users of variation, and how this can be addressed
• support practice and policy research aimed at improving AMS
• develop and supply educational resources to support AMS practice (via the Global Antimicrobial Stewardship Partnership Hub)

Established in 2022, GAMSAS has now accredited the AMS programmes of 10 hospitals, 5 in the UK and 5 overseas. BSAC has worked with AMS experts and teams in these hospitals to assess their AMS systems, processes and practice via desktop reviews and hospital visits. BSAC is currently working with hospitals in a further 10 countries and plans to accredit a minimum of 20 hospitals in 2024 both in the UK and overseas. GAMSAS provides a sustainable approach to AMS via 3-yearly re-accreditation, utilisation of a pool of AMS experts across the world to support the assessment process and collaboration with partner organisations to support access to accreditation across all healthcare economies.

Commitment 4.1 - Clinical decision support

We will reduce avoidable human exposure to antimicrobials by supporting health and social care teams with decision support, risk stratification tools and judicious use of diagnostic tests, underpinned by improved diagnosis coding, to inform shared decision-making and target antimicrobials to patients most likely to benefit.

This commitment signals an evolution of antimicrobial stewardship and the adoption of new ways to safely reduce human exposure to antimicrobials. Enabling genuine shared decision-making is a fresh approach for this NAP . Existing clinical guidance does not contain sufficient useful information on the natural history of infection illness, the prognosis of untreated infection, the benefits and risks of antimicrobials or the alternatives to antimicrobials, to empower patients, enable shared decision-making and reduce demand for and expectation of antimicrobials.

Clinical decision support tools are aids which can guide clinicians in the complex area of treatment choices, especially when there is incomplete information, or in a busy environment. They can help ensure healthcare workers access accurate and real-time information which allows for informed decisions when prescribing antimicrobials. These tools can utilise large data sets, algorithms and local resistance patterns to provide the best possible picture for healthcare workers deciding which antimicrobial to prescribe (or not to prescribe).

Similarly, risk stratification tools (optimising the use of digital health information systems and artificial intelligence) enable a nuanced take on the difficult decisions around when to prescribe antimicrobials and, importantly, when not to. Being able to identify high-risk populations or settings for AMR means surveillance can be targeted and guidelines adapted, resulting in better stewardship. Helping clinicians in identifying the ‘threshold for treatment’ reduces unnecessary prescriptions, and encourages a shift from ‘what to prescribe?’ to ‘whether to prescribe?’

Diagnostics form part of decision support, aiding both the identification of infection and subsequent targeting of specific organisms. This can reduce unnecessary prescribing and overprescribing of broad-spectrum antimicrobials, and directly benefit patients who get the right treatment. Ensuring rapid, accurate diagnostic testing is available when and where needed is therefore necessary in reducing incidence of AMR .

Reducing unnecessary antimicrobial prescriptions is a core undertaking of this NAP . Supporting frontline clinicians in making the best choices regarding antimicrobial treatments, with decision support and risk stratification tools, alongside adequate availability of diagnostic tests in community and hospital settings, will create a clinical environment where the right antimicrobials are prescribed only to those that need them, at the right time.

Case study: artificial intelligence ( AI ) and digital tools

With the increasing digitalisation of the NHS, the next 5 years are crucial in terms of ensuring AMR is embedded as a consideration in digital transformation. AMR interventions can be hampered by poor implementation of digital systems and there is a need to adopt digital technologies that enhance AMS practices.

Innovative digital tools to support prescribers’ decision-making are emerging, such as the Scottish Antimicrobial Prescribing Group (SAPG)’s Antimicrobial Companion app and the MicroGuide app. These applications, and similar tools, may offer the opportunity to improve patient outcomes and rationalise antibiotic prescribing.

AI could further support risk-stratification of patients and targeting of antibiotic treatment based on available data. However, the implementation of AI tools would require the right data being available in the right format to enable ‘big data’ analysis by AI . The effectiveness and safety of AI for decision support depends on fully integrated digital systems with data governance permissions to access a large data lake and apply this learning to optimise decisions for individual patients.

Over the next 5 years, the focus in this space should be on research, evaluation and validation of AI technology (taking advantage of the data infrastructure of the NHS). Further evidence on acceptability to clinicians, clinical outcomes, and cost-effectiveness is needed, before routine implementation in the NHS would be possible.

Prescribing and supply of antimicrobials for humans is increasingly undertaken in the UK by health professionals other than doctors. Since 31 January 2024, antimicrobials have been available from community pharmacies through the Pharmacy First service in England (following similar services in Scotland and Wales). From 2026, all pharmacists will graduate with an independent prescribing qualification. Providing tools to support antimicrobial treatment targeted only to patients who need them is critically important for independent non-medical prescribers to optimise diagnostic and therapeutic decision-making, as is continuing to monitor and evaluate the impact of these services on antimicrobial use in the UK.

Commitment 4.2 - Appropriate prescribing and disposal

We will support health and social care teams to make decisions about the optimal selection of antimicrobials, dose, route and duration of treatment for individual patients, with guidance on spectrum of activity, route of administration, and alternatives in allergy or contra-indication and support patients and health and care professionals to safely dispose of antimicrobials.

Applies to people and the environment.

The UK has a good record in the field of AMS , and this is something to build upon further. There continues to be room for improvement in this area and it is important not to lose sight of antimicrobial use as a driver of AMR . AMS comprises a number of core components including:

• correct diagnosis
• optimal drug
• correct dose
• correct time
• correct route of administration
• optimal duration
• timely de-escalation

Prescribers and patients should also consider the safe disposal of antimicrobials.

Case study: monitoring of prescribing trends

Since 2020, Antimicrobial Resistance and Healthcare Associated Infection ( ARHAI ) Scotland has closely monitored and reported trends in antibiotic use in primary care to assess the impact of the COVID-19 pandemic on prescribing behaviour and antibiotic use in humans.

This assessment used near real-time monitoring of weekly trends in antibiotics used for respiratory infection with reporting for action within NHS boards. ARHAI Scotland has continued this regular monitoring and reporting to enable assessment of the impact of NHS remobilisation from COVID-19 and generate evidence for optimisation of antibiotic prescribing.

This enhanced monitoring information is shared with partners to allow for early detection and understanding of changes in antimicrobial prescribing practices to inform local and national interventions and initiatives.

The first decision for prescribers is whether an antimicrobial needs to be prescribed at all. Diseases may present with symptoms similar to antimicrobial sensitive infections, but may in fact be viral in nature, or of non-infective cause. Utilising the decision support and risk stratification tools, as described above, will help clinicians ensure a prescription is appropriate.

If antimicrobial treatment is suitable for the patient, the next question is which one. Current antimicrobial guidelines are available across the UK, and make recommendations for most infections, with specialist advice available from microbiologists and specialist antimicrobial pharmacists, as necessary. Commonly, broad-spectrum treatment is initiated until culture results with resistance data are available for the patient. Ensuring cultures are sent is therefore an important initial step in targeting treatment.

Penicillin allergy is a common contra-indication to the use of this critical class of antibiotics, forcing clinicians to use alternative treatments, putting patients at increased risk of AMR or adverse effects. Access to penicillin allergy de-labelling services is vital to ensure patients are not denied penicillin treatments unnecessarily.

As set out above, rapid and accurate diagnostics are a leading factor in antimicrobial choice, together with making real-time data available to healthcare workers.

Selecting the most appropriate route of administration is vital to ensure infection is treated effectively while not putting patients at risk from unnecessary use of the intravenous or parenteral routes of administration. Ensuring equitable access to outpatient parenteral antimicrobial therapy ( OPAT ) services is also important, to optimise the efficient use of NHS resources and reduce the risk of a prolonged hospital stay.

The next decision to be made is about de-escalation of treatment, whether that is from a broad-spectrum to a narrow spectrum drug, or from intravenous (IV) to oral treatment. This is a continuous process, depending on the clinical condition of the patient, which can also be aided by systems being put in place to prompt clinicians to consider de-escalation in their management plan for the patient, for instance during the ward round.

The duration of treatment is often delineated in guidelines, which aids in ensuring adequate length of treatment. However, growing evidence suggests shorter treatment durations than currently recommended may often be appropriate (see Palin V and others, Shorter and longer courses of antibiotics for common infections and the association with reductions of infection-related complications including hospital admissions . Clinical Infectious Diseases, 73, 10, pages 1805 to 1812 (2021)). Further studies in this field are necessary and we may soon see shorter treatment durations reflected in local antimicrobial guidance documents and prescribing support tools for certain infections. 

These decision choices are reflected under ‘Recommendations to prescribers’ in NICE guideline (NG15) , which also encourages prescribers to consider AMR in their prescribing decision making:

When deciding whether or not to prescribe an antimicrobial, take into account the risk of antimicrobial resistance for individual patients and the population as a whole.

Digital and non-digital technologies play an important role in enabling timely clinical decision support, and incorporation of user experience is vital as part of the development, validation and evaluation process of these tools.

Commitment 4.3 - Use of behavioural interventions

We will use and apply evidence, including social and behavioural sciences, across all sectors to better understand, develop and implement behaviour change interventions and disseminate those strategies that are effective in bringing about improvement.

Applies to people, animals, plants and the environment.

This commitment relies on the active participation of public and private sector bodies, including investors, across the human health, animal health, the food chain and environment communities. There is a central role for members of the public too, as patients, consumers, animal owners and investors.

Case study: veterinary antimicrobial use behaviour change in the UK

In the veterinary sector, the UK has been supporting changes in behaviour for several years now and this has been central to the substantial reductions seen in antimicrobial use in animals in the past decade.

The UK’s 59% reduction in the use of antibiotics in food-producing animals makes it one of the lowest users of antibiotics across Europe, and the lowest of those countries with a significant livestock farming industry. Impressively, this has been achieved through a voluntary, sector-led approach, which has transformed attitudes and behaviours around antimicrobial use and has resulted in antimicrobial stewardship becoming a principle which is embedded in UK agriculture.

Industry’s ownership of the issue (led by the Responsible use of Medicines in Agriculture ( RUMA ) Alliance) has been critical, as well as the collaboration between industry and government, which varies from the more widely implemented regulatory and enforcement approaches seen in other countries.

Some of the fundamental principles of behaviour change which have enabled this success include:

• avoiding unproductive blame and guilt
• making the issue relevant and salient
• using ‘regulation by reputation’
• using the right messengers
• following the incentives

Further lessons learnt from this approach can be found in Tackling antimicrobial use and resistance in food-producing animals , a case study produced for the Food and Agriculture Organization ( FAO ) of the United Nations.

Facilitating behaviour change across sectors to protect the use of antibiotics is challenging. It needs to be easy for all involved to make the right decision about whether and how an antimicrobial should be used. Importantly, misconceptions and misperceptions about infections, AMR and AMS should be addressed across all sectors and all communities. Doing so depends on evidence base for behaviour change interventions which support improved antimicrobial use (informed by use of diagnostics and clinical scoring tools) and IPC practices. This will include significant learning from the COVID-19 pandemic. Evidence will inform implementation of practical, effective interventions to improve professional practice and public behaviours in the UK.

Outcome 5 - AMR workforce

By 2029, the UK’s human health, animal health and agriculture workforce and leadership have the appropriate objectives, support and capabilities to tackle AMR , empowered by clear, responsible governance and education.

This outcome has 5 commitments:

• health and social care training
• health and social care workforce
• health and social care governance
• veterinary workforce knowledge and skills
• systems to support animal health

Commitment 5.1 - Health and social care training

We will further embed, and will require, the completion of appropriate IPC and AMS training for all health and social care workers and students, to support implementation of best practice for IPC and AMS in their setting and, for specialist posts, to provide career pathways to promote skills retention and succession planning.

Success of this action plan depends on the practical application of its contents, which is in turn dependent on successful training. Embedding best practice within the curriculum, at undergraduate and post-graduate level, of those in frontline health and social care services is critically important. Ensuring that training programmes instil not just theoretical knowledge but hands-on experience in implementing IPC and AMS measures will improve IPC , infection management and antimicrobial stewardship and build on the already substantial common awareness of these issues in the health and care community.

In 1847, the Hungarian obstetrician Ignac Semmelweis introduced mandatory handwashing for those who wanted to enter the labour room, resulting in a remarkable decrease in maternal deaths from puerperal fever. The causative agent was still unknown, but the effectiveness of good IPC had been proven over 175 years ago.

IPC is paramount to reducing the burden of AMR , and it is everyone’s business. Everyone working in health and social care has a role to play in preventing the spread of infection within health and care settings, including students and visitors. Ensuring that staff have the requisite skills and training to implement and improve IPC practices is the responsibility of each employer.

Social care environments such as care homes have at times been overlooked in the arena of AMR programmes, but they are important places where gains can be made to reduce levels of resistant organisms. Poor antimicrobial stewardship in the social care setting not only affects residents but also carries risk to the wider community, given the mobile nature of staff, visitors and residents. According to the OECD health policy study on Embracing a One Health framework to fight antimicrobial resistance , challenges involve:

• the vulnerability of residents to infections
• difficulty in IPC implementation compared with the hospital setting
• limited access to rapid diagnostic testing
• preventative antimicrobial prescribing (which may be appropriate depending on context but can increase risk of AMR )
• limited surveillance capabilities

(See the ‘Long-term care is an emerging priority area for tackling AMR with a great potential for improvement’ section of the ‘Addressing antimicrobial resistance’ chapter of the above OECD policy study).

Similarly, institutional settings such as migration centres can be at risk of spread and outbreaks of infectious diseases, including infections from geographic regions with high resistance prevalence, and ensuring good IPC measures and AMS are in place in these settings is important in reducing AMR .

While some IPC measures are incredibly effective, further research is needed to gain an even better understanding of where the focus of efforts should be. Carrying out high-quality research into the effectiveness of current IPC programmes should also be encouraged, including the impact of specific measures, to ensure time and effort is spent on informed interventions.

Commitment 5.2 - Health and social care workforce

We will implement a system-wide approach to strong IPC and AMS in health and social care settings, aligning workforce planning with workforce needs and considering system-wide capacity and capability to mitigate and respond to incidents.

A system-wide infection management approach, which includes IPC and AMS , will deliver optimal outcomes for patients as well as improving the usage of antimicrobials. Investing in system strengthening and supporting the workforce for AMS and IPC is a must for the NHS, with AMR likely to increase the pressure on the system. While IPC measures may confer up-front costs, they are likely to be cost-effective in the long term through the avoidance of downstream costs of treating infections, especially resistant infections which typically lead to longer stays in hospital (see the OECD health policy study on Embracing a One Health framework to fight antimicrobial resistance ) and more complicated treatment (see Manoukian S and others, Bed-days and costs associated with the inpatient burden of healthcare-associated infection in the UK . Journal of Hospital Infection, 114, pages 43 to 50 (2021)).

An infection management approach includes national, regional and local integration of AMR teams with those working within IPC and those managing patients with mild and severe illness (including sepsis). It includes prevention of infection, use of diagnostics and appropriate treatment (including for resistant infections). Effective infection management is underpinned by data, education and communication. This is illustrated in figure 5, below.

Figure 5: an infection management approach

Delivery of high-quality healthcare requires consistent training across specialisms, including public health, microbiology, epidemiology and pathology. There is also a need to embed IPC and AMS as everyone’s job rather than leave it to specialists alone. The COVID-19 pandemic demonstrated that all healthcare professionals benefit from some expertise in managing infections. It is critical to embed infection management capability widely across the NHS and care settings as infections are a common reason for seeking help as an emergency, being admitted to hospital, being admitted to intensive care and dying in hospital. An informed workforce will ensure that resources are appropriately allocated according to risk, with the impact of infections not limited to individual patients but affecting public health at large. Role-specific training will be critical to empowering all staff groups, including physician assistants and pharmacy technicians, to implement IPC and AMS principles according to their specific roles and responsibilities.

A crucial element to improving appropriate and timely usage of antimicrobials in patients with both mild and severe infections is the development of useful clinical pathways that assist in the management of patients with suspected infection. Taking a system-wide approach is essential to ensure that evidence-based, practical interventions can be introduced across settings, including community care as most resistant infections are acquired in the community (see Manoukian S and others, Bed-days and costs associated with the inpatient burden of healthcare-associated infection in the UK . Journal of Hospital Infection, 114, pages 43 to 50 (2021)).

Commitment 5.3 - Health and social care governance

We will support appropriate systems for leadership and governance responsibility for infection management, AMS and IPC in health and social care providers and commissioning bodies.

The actions within this NAP focus specifically on AMR but reducing AMR must be embedded throughout the healthcare system. We need to put the right structures in place to centre infection management, AMS and IPC in our health and social care delivery. Efforts to tackle AMR in healthcare settings should not heavily rely on individual ‘champions’ - this is not a sustainable solution to this substantial threat.

All sectors can and must be involved in the work of reducing the number of infections, with social care, primary care and hospital care all potential places where transmission may occur. It is vital that all commissioners in these sectors ensure that effective and structured AMS and IPC programmes are in place. Appropriate systems for leadership and governance will enable implementation of clear policies and procedures, allocation of appropriate resource, effective monitoring and evaluation, and resilience to evolving threats.

We will work with the Care Quality Commission (CQC) and other regulators to support providers of health and social care services to meet their obligations, as set out in regulations (including the Health and Social Care Act 2008: code of practice on the prevention and control of infections in England ).

Commitment 5.4 - Veterinary workforce knowledge and skills

We will work alongside the veterinary profession to ensure that they have the necessary data, knowledge and skills so that veterinarians are empowered to advise on good husbandry and animal management strategies for disease prevention, prescribe antimicrobials responsibly, and, where appropriate, recommend evidence-based alternative treatments in place of antimicrobials.

Applies to animals.

Animal health targets

This NAP sets targets for antimicrobial use in humans but there are already targets in place for different animal sectors , as set out by the RUMA (Responsible use of Medicines in Agriculture) Alliance. The current sector targets cover the period from 2021 to 2024. These are tailored to the features of each sector:

• understanding and benchmarking use
• engagement between farmers and vets
• the development of health plans
• for those sectors where there is sufficient data and room to set targets (for example, pigs and gamebirds), the focus is on achieving specific antibiotic use reductions (30% in pigs and 40% in gamebirds)
• across the sectors, there will be efforts to improve farmer and vet training on antibiotic stewardship, increase vaccine uptake, and increase the uptake of health planning and governance to ensure that highest priority critically important antibiotics ( HP-CIAs ) are only used as a last resort

The collection and collation of antibiotic use data is crucial for monitoring antibiotic use in animal sectors nationally, identifying changes and trends, and exploring any changes. The ruminant sectors are aiming to increase the availability of antibiotic use data by encouraging the use of the Agriculture and Horticulture Development Board (AHDB) Medicine Hub and equivalent initiatives across the UK. Medicine Hub, launched in 2021, is a centralised antibiotic use data collection system. It has captured over 6,500 farm-level data sets so far.

The hub is a central collation point for antibiotic use data in ruminants, compatible with a wide range of antibiotic use data collection systems and with a range of existing industry software. The PIRU evaluation of the first NAP emphasised the need to continue improving the availability of antimicrobial use data in animal sectors.

When the current sector targets end in 2024 the industry has committed to create a new set of ambitious targets.

In the animal health sector, there has been a focus on reducing exposure to pathogens and improving prescribing practices by veterinary professionals, underpinned, where appropriate, by diagnostic tools. In the UK, many stewardship initiatives have been sector led, centred around collaboration between farmers, vets and government organisations. This has led to sustained behaviour change and significant decreases in animal antimicrobial use.

Antimicrobials are essential for veterinary professionals to treat infections and infectious diseases in animals under their care. Antimicrobial stewardship is therefore critical to preserve the availability of effective antimicrobials for animal health. Vets are the gatekeepers of antimicrobial use in animals. Responsible prescribing in the animal sector will help preserve the efficacy of critical medicines for humans and animals. Responsible prescribing is underpinned by evidence-based guidance, clinical decision tools, surveillance data and emerging research on AMR and behaviour change. Prescribing can be avoided through good animal husbandry and prevention tools such as vaccines.

Case study: Arwain DGC

Arwain DGC is a collaborative AMS initiative in Wales led by Menter a Busnes with project partners Iechyd Da, Welsh Lamb and Beef Producers, the University of Bristol and Aberystwyth University. The Arwain Veterinary Prescribing Champions ( VPC ) network has brought vets from 90% of farm or mixed practices in Wales together since 2020 to participate in a programme of training in responsible veterinary medicine use alongside discussion groups, peer learning, workshops, webinars and other in-person and online events.

The VPC network has designed and implemented antimicrobial stewardship interventions within vet practices. The VPC network has worked together with Aberystwyth University and other Arwain DGC project partners to develop 2 national antimicrobial stewardship interventions for the profession aimed at supporting practising vets to prescribe responsibly and develop strong working relationships with their farmers to ensure antimicrobials are used as prescribed.

The code of prescribing conduct is a voluntary code of conduct intended to drive positive change within Welsh farm vet practices, to ensure consistency and accountability in prescribing and to signpost farming clients towards practices that are actively engaged with responsible antimicrobial use, the VPC Network and the Arwain DGC program.

The network has also produced practical, useable clinical guidelines for 6 significant diseases in cattle and sheep:

• watery mouth (E. coli enterotoxaemia) - sheep
• joint ill (neonatal polyarthritis) - sheep
• lameness (scald, digital dermatitis, CODD ) - sheep
• bovine respiratory disease - cattle
• neonatal diarrhoea - cattle
• mastitis (selective dry cow therapy) - cattle

By combining the practical experience of clinical farm vets with literature reviews conducted by academics at Aberystwyth University, these clinical guidelines were launched in 2023 and are set out in a range of resources, including quick reference guides as a practical, on-farm resource for vets, in online documents, which include the underpinning literature reviews and in treatment planners, which farmers and vets can complete together for display to all farm staff.

This NAP will build upon the successful reduction of antibiotic use in animals over the past decade, including expanding stewardship work to the companion animal and equine sectors. In 2023, an online training initiative was launched, providing over 20 hours of continuous professional development relating to improving how antibiotics are used in dogs, cats and horses (funded by the VMD ) - including practical modules looking at different diseases and conditions where antibiotics are used and modules on diagnostics, behaviour change and infection control. This complements other recent companion animal initiatives.

The voluntary collaborative approach taken by the UK to reduce antibiotic consumption in animals was led by the RUMA Alliance, an independent non-profit group which aims to promote the highest standards of food safety and animal welfare. RUMA ’s Targets Task Force (TTF), composed of a specialist farmer and vet representing each livestock sector, developed sector-led targets for each sector by studying their systems closely and identifying opportunities for improved antibiotic use and antibiotic reduction. Targets set in 2017 led to a 52% reduction in antibiotic use and a 79% reduction in highest priority critically important antibiotic ( HP-CIA ) sales for UK food-producing animals.

Commitment 5.5 - Systems to support animal health

We will support the veterinary profession, the livestock and aquaculture industry, retailers and/or processors and animal keepers to ensure animal health and welfare is protected and that animal keepers have the necessary knowledge, skills and data to implement measures to prevent and control disease and infections, reducing the need to treat animals with antimicrobials and, where antimicrobials are necessary, adhere to responsible use and disposal practices.

Farming is an important industry in the UK, representing more than £14.7 billion and more than 72% of its total land area, according to Defra farming and environment evidence packs . In addition, it is the source of high-quality food for our population and a principal component of the UK trade market.

The UK has made huge strides in reducing the use of antibiotics in animal production, through tailored sector-specific approaches, improving husbandry and adopting disease prevention measures to reduce reliance on antibiotics. This collaborative voluntary approach with sector-led targets has resulted in a change of culture of antibiotic use in farming, with AMS now firmly embedded in UK agriculture.

Pivotal to this is supporting animal health and welfare, which reduces the need for antimicrobials. This can be done through improved husbandry, biosecurity and animal IPC . The Animal Health and Welfare Pathway is one example of an initiative to support farmers. The pathway will help to support this commitment by reducing endemic disease in cattle, pigs and sheep to reduce the need for antimicrobials. Programmes may involve diagnostic testing, veterinary advice, vaccination, improvements to on-farm management and active management planning. The PIRU evaluation of the first NAP reinforced the value of initiatives that facilitate engagement between farmers and veterinarians, and the international component of the evaluation found novel policy experiments aligning farmer and veterinarian goals in the Netherlands. More information will be available in the  PIRU  beef cattle report, due to be published on the  PIRU  website .

Current efforts to reduce AMR in animals have focused mainly on food-producing animals. However, in 2023, according to Pet ownership in the United Kingdom (UK) 2012 to 2023 published by Statista, 57% of UK households owned a companion animal. The principles of responsible use of antimicrobials applies to the companion animal and equine sectors as much as to food-producing animals. It is therefore essential that veterinary professionals and animal keepers of companion animals and equines have the appropriate guidance in place to make informed decisions about antimicrobial use.

There are lessons to be learnt in reducing antimicrobial use between different sectors. For example, when implementing services that allow community pharmacists (the private sector) to supply antibiotics to humans, there is an opportunity to learn from the collaborative, voluntary approach taken to improve antimicrobial use in the veterinary sector.

Outcome 6 - Innovation and influence

By 2029, the life sciences and technology sector (including government, public and private sector organisations) are actively engaging and responding to the demand for new tools, technologies and interventions for tackling AMR .

This outcome has 4 commitments:

• AMR solutions
• subscription models
• overcoming market barriers
• improvement and adoption

Commitment 6.1 - AMR solutions

We will work across the public sector, regulators, academia and industry to fund and deliver innovative scientific research to develop vaccines, diagnostics, antimicrobials and alternative therapies (including bacteriophage, polyclonal antibodies and host-directed therapies), which meet UK and global needs.

Antimicrobials are the only tools that reliably treat infections in humans and animals, but resistance is outpacing the development of new antimicrobials. There has been no new class of antibiotics since the 1980s. Alongside the development of new antimicrobials, a range of other tools to tackle resistance is needed. AMR is a complex problem and there is no single, technological solution for it.

The discovery and development of a range of new products for preventing, diagnosing and treating infection is essential to combat AMR and ensure we can continue to treat infections and protect public health and animal welfare. The products we need include:

• vaccines to prevent the emergence of infection
• diagnostic tools to identify infections and inform appropriate infection management
• new antimicrobials to treat resistant infections in people and better target treatment
• novel alternative, evidence-based therapies, such as bacteriophages

Science, Innovation and Technology Committee findings on the antimicrobial potential of bacteriophage

In February 2023, the Science, Innovation and Technology Committee ( SITC ) launched an inquiry into the antimicrobial potential of bacteriophages . Bacteriophages - or ‘phages’ - are viruses that can kill harmful bacteria but do not harm humans. The inquiry examined evidence on the safety and effectiveness of phages and the barriers to their development and use.

The inquiry found that:

• phage safety and effectiveness had been shown using observational clinical studies, but further research on phage biology and interactions is needed
• increased investment into phage research would enable more robust studies to be performed and higher quality clinical data gathered
• there is a ‘translation gap’ between phage research and the application of phages in clinical settings
• phage manufacturing within the UK must meet the high standards for pharmaceutical manufacturing set out in good manufacturing practice (GMP)
• phages could be useful tools across sectors, responding in a One Health way

The government response to the SITC report on bacteriophages was published on 1 March 2024.

The commitments in this section of the NAP lay the groundwork to develop a suite of tools (rather than focusing on a single technology) which will contribute to addressing AMR . As set out elsewhere in this NAP , we also need to apply genomic medicine tools to identify and protect vulnerable patients from harm from antimicrobials and digital technologies to promote optimal prevention, diagnosis and treatment of infections.

In addition to supporting the development of these tools, demonstrating their value through strengthening the evidence base for the economics of AMR is essential. Greater understanding of the societal value of new vaccines, therapies, diagnostics and other tools, beyond the benefit to the individual recipient, will support effective decision making over the next 5 years. This area is highlighted within our top 10 research priorities, set out in the ‘Outcome 7 - Using information for action’ section.

Case study: Open Innovation AMR

UKHSA supports open and collaborative work on AMR by offering its expertise and facilities to researchers. An infrastructure award from NIHR , Open Innovation AMR , supported the development of new facilities to enable evaluation of a range of interventions. UKHSA has capabilities in its Porton Down facility which can be accessed by AMR researchers, in academia and industry, including:

• a screening cascade for evaluation of novel antimicrobial therapies
• a unique facility to investigate the role of the built environment in transmission of AMR and the effectiveness of IPC procedures

UKHSA offers a screening cascade which can be accessed for the testing of traditional and non-traditional therapeutic approaches against multidrug resistant bacteria, fungi, and viruses. Expertise can also be applied to the evaluation of new diagnostics and antimicrobial susceptibility tests. Visits by students, post-doctoral researchers or staff to Porton Down are supported, and training is provided in the microbiological techniques used in screening therapies for antimicrobial activity against a large library of multidrug resistant clinical isolates. Work under this programme has resulted in 5 patent filings for novel therapeutics and diagnostics, with a company established to commercialise the lead technology for rapid antimicrobial susceptibility testing (iFAST Diagnostics).

The UKHSA Porton Down facility contains a full-scale, fully functional modular ward which was designed according to current UK guidelines and built to simulate a real-life clinical setting. The facility has a 4-bed ward and isolation rooms with dedicated heating, ventilation and air conditioning systems, realistic water and drainage systems and appropriate surfaces, fixtures, fittings and furnishings. This enables us to study how hospital facilities can be designed and operated to improve IPC and reduce transmission of antibiotic resistant infections, contributing to improved antibiotic stewardship. A range of studies are underway with collaborators looking at methods to control transmission of infections through fomites and aerosols, pathogen spread through hospital water systems and developing IPC guidance on hospital laundry and safe decontamination of linen.

Commitment 6.2 - Subscription models

We will implement purchasing arrangements for new antimicrobials that de-link the price paid for antimicrobials from the volumes sold, monitor and evaluate impact, and advocate for the wider use of these ‘subscription models’ in other countries.

There is a need to address the urgent issue of bringing new antimicrobials to market. Investment in novel antimicrobials is widely seen as commercially unattractive by industry. The high research and development costs and low returns (due to restrictions in use to slow down resistance) have led to market failure.

AMS (prescribing the right antimicrobial to treat the right pathogen at the right time), which is critical to preserve the effectiveness of new products, often means that new antimicrobials are used very little in the first few years after they have received marketing authorisation. Therefore, companies do not see the return on investment that they can with other innovative products where uptake is encouraged rather than restricted.

NHS England and NICE launched a pilot project in July 2019 to test a payment mechanism that de-linked the price paid for antimicrobials from the volumes sold, using a NICE -led healthcare technology assessment. In 2022, the evaluation process was completed and, in a global first, subscription style contracts were awarded in July 2022. The pilot provided the first health economic quantification of the full value of 2 antimicrobials, capturing the population health benefits that extend beyond the benefits for people receiving the drug. In light of lessons learnt from the subscription model pilot project in England ( NICE and NHS England), proposals have been developed to scale the model to more antimicrobials across the UK - see the Antimicrobial Products Subscription Model: consultation on proposals .

The UK represents a small proportion (approximately 3%) of the global antimicrobial market and therefore cannot solve the issues within the global antimicrobial pipeline alone. The adoption of pull incentives in other markets, in combination with the UK’s scheme, should create a meaningful incentive for global investment in antimicrobials. Sharing progress and learning from the project with international partners is an important part of the UK approach. This has been strengthened by advocacy from the UK Special Envoy on AMR , Professor Dame Sally Davies, working with finance ministers, including during the UK’s G7 presidency and subsequent Japanese and German presidencies.

There is also government support for the development of new antibiotics, including financing basic science and early-stage innovations. For example:

• UK Research and Innovation ( UKRI ) finances basic science
• the UKHSA Drug Discovery Group is developing procedures for the discovery of new drug combinations that may be effective against resistant pathogens
• DHSC ’s GAMRIF invests in early-stage innovations
• NIHR invests in a wide range of clinical and applied research

Commitment 6.3 - Overcoming market barriers

We will collaborate across the public sector, with academia and with industry to identify needs and to overcome market barriers, to enable new products to move from discovery to market in an equitable and sustainable way.

As highlighted by the Center for Global Development’s report, A new grand bargain to improve the antimicrobial market for human health , there are substantial barriers preventing the tools needed to tackle AMR from making it to market. Discovery needs to be matched with a supportive environment in which those new creations can be appropriately regulated, adopted and taken up in practice. There are specific challenges for different products. We want to help both small and large innovating companies bridge the ‘valley of death’ for novel therapeutics, vaccines and other tools targeting bacterial pathogens. This will primarily be implemented via Innovate UK’s pathways to antimicrobial clinical efficacy ( PACE ) initiative.

Case study: PACE

PACE is a UK-based £30 million programme of funding and support to be deployed over 5 years. ​ PACE will bring together the right funding, resources and partnerships to help innovators progress their early-stage antimicrobial drug and diagnostics projects with greater speed, support and confidence - giving the best AMR innovations the greatest chance of success. ​ PACE is a collaboration between 3 leaders in the UK health innovation and research community:

• Innovate UK
• Medicines Discovery Catapult

​ PACE harnesses their unique expertise, catalysing and working with the global AMR community to accelerate the speed of innovation to mitigate the risk of AMR . ​

There are 3 main strategic pillars to the PACE initiative:​

• strengthen the pipeline - PACE will grow a pipeline of high-quality antimicrobial drugs and associated diagnostics aligned with unmet needs​
• enable preclinical translation - PACE will provide innovative researchers in academia and SMEs the funding, advice and support they need to build de-risked and investment-ready assets​
• accelerate progress and overcome barriers -  PACE aims to convene collaborative networks to identify barriers to innovation, advance programmes, and drive new collaborative research and development

Through these mechanisms, PACE will further embrace innovation and maximise the diversity of approaches to meet the AMR threat. The PACE initiative will aim to provide wrap-around support for AMR products and their developers, going beyond a simple funding model.​  PACE aims to deepen and strengthen data packages for AMR assets and work alongside product developers, regulators and experts to identify the best partners to plug gaps in resource or capabilities.​ The intent is to improve the potential for future onward progression and investment.​

Clinical trial infrastructure, including the use of platform trial methodology, successfully deployed by the NHS for the rapid evaluation of COVID-19 therapeutics, should be optimised for clinical development of antimicrobials, vaccines and diagnostic tests across pathogen types and AMR associated disease locations. This can help reduce the size (and cost) of trials targeting rare but increasingly resistant pathogens. Investing in building and retaining talent in non-viral infectious diseases is critical to ensuring we can develop new antimicrobials in the future (see The Wellcome Trust 2020 report, The global response to AMR : momentum, success and critical gaps ). Other infrastructure developed for COVID-19 can also be built on to tackle AMR . For example, monitoring of the effectiveness of deployment of novel antimicrobials can be adapted from the novel therapeutics surveillance programme at UKHSA .

The development of new antimicrobials, even if rapidly accelerated by investment into research and the advancement of digital tools, is not a magic bullet which will solve the problem of AMR . As new antimicrobials are developed, they will exert additional selection pressures on pathogens and therefore need to be used with great caution. For that reason, our efforts on antimicrobial stewardship (as described in the ‘Outcome 4 - Antimicrobial stewardship and disposal’ section) remain of the utmost importance.

Case study: vaccines and AMR

Vaccines are a central part of infection prevention by:

• reducing sensitive and resistant bacterial infections in vaccinated people and unvaccinated people (through herd immunity)
• reducing antibiotic use by reducing the number of infections which require treatment with antibiotics

In its 2021 action framework , the WHO describes how vaccines can contribute sustainably and equitably to the tackling of AMR  by preventing infections and reducing antimicrobial use.

It included 3 goals:

• expand use of licensed vaccines to maximise impact on AMR
• develop new vaccines that contribute to prevention and control of infections
• expand and share knowledge of vaccine impact on AMR

The role of animal vaccines in reducing the development of AMR is part of a suite of measures required for successful infection control.

Commitment 6.4 - Improvement and adoption

We will drive improvement by assessing and regulating novel technologies and approaches at pace, using evidence to increase timely and appropriate adoption.

While development of new products is a crucial element of tackling AMR , it is only one piece of the puzzle of making sure they are used as needed. The pathway to market is underpinned by assessment of a product’s value to end users and by robust regulation. It is critical to ensure that safe and effective products work in real-world settings (particularly in human health and care and veterinary and farm settings).

Understanding of the social and behavioural factors involved in adoption of new products, tools and guidance will be strengthened through research commissioned in support of the top 10 AMR research priorities set out under the ‘Outcome 7 - Using information for action’ section.

We need to understand what works best to help staff on the frontlines. This will be supported by clarity on assessment, regulation and incentivisation for use of new products.

The Veterinary Medicines Directorate ( VMD ) is the regulator of veterinary medicines in the UK with the main objective of protecting animal health, public health and the environment. This includes fostering advances in pharmaceutical technology and novel therapies, offering scientific advice to strengthen marketing authorisation applications and providing robust safety and efficacy assessment of new veterinary medicines before approval in the UK.

The Medicines and Healthcare products Regulatory Agency ( MHRA ) is responsible for ensuring patients in the UK have access to safe and effective medicines and medical devices. The agency supports innovation from point of invention to point of care, and ensures that the quality, safety and efficacy of medicinal products and medical devices is demonstrated with robust scientific evidence along the entire product lifecycle. MHRA works with innovators to enable them to provide this evidence by developing reference reagents to benchmark the methodologies used to evaluate them, as well as providing guidance to understand what evidence is needed for regulatory approval.

Novel products, which are needed to tackle AMR , can present challenges to regulators as well as the scientific community. MHRA is therefore working closely with innovators from the early stages of product development to ensure that the regulatory science and frameworks needed to get safe and effective products to market are in place. Guidance is provided to help innovators understand what evidence MHRA requires in order to evaluate the quality, safety and efficacy of new products.

Outcome 7 - Using information for action

By 2029, public policy, clinical and funding decisions on AMR will continue to be informed by robust surveillance, modelling, strengthened scientific research, interconnected data sets and emerging international evidence.

• evidence generation and use
• research networks

Surveillance programmes generate information for action. Indeed, research and surveillance are closely related and will be coupled through the lifespan of the NAP . Surveillance continues to inform the development of research questions just as research outputs also inform priorities and direction setting for surveillance. This helps to set out what the unknowns are and what the most urgent areas are for monitoring levels of AMR and use of antimicrobials.

Commitment 7.1 - Evidence generation and use

We will fund, collect, generate and use research, innovation and evidence to improve understanding of AMR , its impact and how to mitigate it, with a focus on enabling the necessary research infrastructure, knowledge transfer and disciplines to meet identified research priorities (including those set out in the ‘top 10’).

Evidence will inform the actions taken in this NAP , across all sectors, practitioners and settings.

The UK already invests extensively in research to enable us to tackle AMR . UKRI directly supports and enables UK researchers to carry out unique research, in collaboration with colleagues around the world, to improve our understanding of AMR and to deliver innovative and effective AMR solutions. For the human population, DHSC invests over £1 billion a year in health and care research through NIHR , including funding of Health Protection Research Units ( HPRUs ), partnerships between UKHSA and academia. Through NIHR , DHSC will be investing up to £11 million of funding by inviting applications for HPRUs addressing healthcare associated infections and AMR .

NIHR funding for AMR research has seen a year-on-year increase in recent years. During delivery of the first NAP (from 2019 to 2024), NIHR programme funding for AMR research totalled £88 million.

Over the past 5 years, this has included: 

• programme funding for researcher-identified topic areas across AMR
• 2 NIHR HPRUs with a specific focus on AMR and healthcare associated infections ( HCAIs ), based at Imperial College London and the University of Oxford
• numerous career development awards, PhDs, fellowships and professorships in AMR through the NIHR academy

This does not include NIHR infrastructure or Clinical Research Network support. NIHR also supports research into AMR in LMICs , with official development assistance ( ODA ) funding through the NIHR Global Health Research programme. 

Through GAMRIF , DHSC funds and leverages wider investment in new innovative AMR research and development. A recent success was a new, first-in-class antibiotic (in over 30 years) zoliflodacin, which is in phase 3 clinical trials.

While there is a significant amount of research and evidence generation on different areas of AMR across the UK academic landscape, there are still unknowns in terms of our basic understanding of AMR , its associated risks and effects, and how best to mitigate it. In addition, there are areas where research has resulted in new interventions, but evaluation, social sciences, or implementation research is needed to drive use of the outcomes of research in practice.

Top 10 research priorities 

To provide clarity about our priorities for AMR research which will best support policy, we have developed 10 AMR research priorities, set out as questions that UK policy makers most want answered. It was informed by stakeholder engagement and collaboration with funders, and by other research prioritisation exercises, including the WHO ’s 40 One Health AMR research priorities .

The top 10 is intended to identify priorities, not gaps, but there are some topics within AMR where there is a lack of evidence. For example, antifungal resistance has emerged as a rising threat within the environment which is not fully understood.

Government organisations will work with research funders in the UK, to support the top 10, remaining responsive to the most pressing research needs to inform policy. Some specific research questions for each of the top 10 research priorities can be found in Appendix C.

1. What is the cost of AMR ?

This priority is intended to build an understanding of the economics of AMR . There is currently a lack of evidence to provide a full economic case for interventions tackling AMR . Research to define and understand the costs and values of interventions and equipped with cost-effective tools to tackle AMR , will be important to confront the AMR challenge.

2. What is the relationship between  AMR  and health disparities?

This priority is intended to understand how socioeconomic determinants of health interplay with the susceptibility, risk, burden and impact of infections and rates of chronic infection. Building evidence of the risk and outcomes for vulnerable groups is important to inform appropriate action to address AMR . It is vital to understand how to facilitate timely patient access to relevant resources, services and treatment across vulnerable groups.

3. How to influence public awareness and behaviour on AMR ?

This priority is focused on how to improve understanding and awareness of AMR to empower and equip the public to act where appropriate.

4. How to address AMR in international settings?

This priority considers how to ensure that research on how to reduce and address AMR is applicable to international settings and population groups with different needs. This priority includes understanding what can realistically be achieved within low income settings and contexts where there may be limited resources and accessibility issues.

5. What are the basic drivers and effects of AMR , and how does it spread?

This priority focuses on strengthening understanding of the basic drivers of AMR , including how it spreads and evolves in the built and natural environments. There is still a lack of understanding in what drives AMR , how it can be characterised and how it spreads. There is a need to understand what drives resistance, for example how Gram-negative infections spread in the built environment and high-risk settings and understanding the impact of sewage overflows and the spread of resistance genes through soils, waterways, lakes and the seas.

6. How can we prevent AMR from spreading?

This priority focuses on how to mitigate the spread of AMR to minimise risk to humans and animals (including companion animals). Healthcare settings, and particularly hospitals, are a very high priority for understanding what works to reduce AMR and avoid its spread. However, there is also a need to understand and evaluate what works to mitigate AMR spread through the natural environment and if there are unintended consequences associated with interventions.

7. How can we optimise the use of antimicrobials?

This priority is intended to understand what works to optimise the use of antimicrobials and diagnostics across sectors. This might include consideration of shorter courses, targeted dosage, automatic stopping, rapid point of care tests and other novel approaches. There are fundamental gaps in our knowledge of antimicrobial use in human healthcare, animals and plants including knowing what is safe and appropriate as a form of treatment while minimising AMR .

8. What methods can be used to prevent, treat and manage infections without antimicrobial medicines?

This priority is focused on the most effective, and safe, non-antimicrobial medicine routes of care, including at home and community-based methods, for preventing infection, treating worsening infection and managing chronic infection in humans and animals. It may include building evidence for how individuals can safely treat their own infections, or receive treatment at home and in the community, through over-the-counter pharmaceutical and non-pharmaceutical methods like painkillers, nutrition and hydration.

9. How can we drive innovation of new products for tackling AMR ?

This priority is intended to ensure we can capitalise on the discovery of new products for tackling AMR (including prevention technologies, vaccines, diagnostics and new or alternative therapies), drive innovation, and overcome market barriers. Work is needed to strengthen the pipeline of new and alternative products that can both prevent infection (vaccines) and treat them (new antimicrobials and alternatives like phages) and ensure optimal treatment (diagnostic tests).

10. How can we ensure what is known to work is implemented?

This priority is intended to strengthen understanding of how to maximise adoption of existing, effective products, including for application in different sectors and global settings to prevent and manage infection. Improving implementation of effective interventions is essential to overcoming AMR . This includes enabling the uptake of products across settings where infections are controlled and ensuring adherence to interventions and tools on the front lines.

Figure 6: top 10 research priorities

Figure 6 shows that of the top 10 research priorities:

• numbers 1 to 3 are cross-cutting priorities
• number 4 is part of being a good global partner
• numbers 5 and 6 are part of reducing the need for, and unintentional exposure to, antimicrobials
• numbers 7 and 8 are part of optimising the use of antimicrobials
• numbers 9 and 10 are part of investing in innovation, supply and access

Application of the top 10 

These research priorities should be considered through a One Health lens. This does not necessarily mean all research questions must cover more than one sector or discipline. Rather, that researchers should, for example, show they are aware of the wider context of AMR and consider where findings about what works to reduce AMR in one sector, setting or community could be applied in another.

Research to support the top 10 is underpinned by several enablers including, but not limited to:

• laboratories and equipment
• clinical trial infrastructure
• healthcare data platforms
• integrated One Health surveillance
• the research workforce

While this top 10 reflects the priorities of policy makers in the UK, research does not take place in a vacuum, but is part of a global system. Researchers may consider the international application of interventions designed for the UK context, and vice versa.

Case study: GAMRIF gap analysis

DHSC commissioned Ecorys to conduct a gap analysis of the current AMR research and development landscape to inform GAMRIF ’s funding decisions and identification of potential areas for future intervention. Findings were published in January 2023.

The analysis, which has informed the development of the top 10 research priorities in this NAP , found that there are some significant gaps in:

• operational research to reduce AMR in LMICs (noting that innovations and interventions exist in high income countries are not always feasible to adapt in LMIC settings)
• assessment of the feasibility and cost of regulatory measures in LMICs
• more openly available data and data sharing across countries (through harmonised surveillance) to further research and development on AMR solutions
• technical solutions which are relevant to LMIC settings (which may have different needs in terms of the pathogens and syndromes which have the highest burden)
• awareness about AMR , especially in plants and the environment, and animal health

Researchers in the UK are already doing a significant amount of work to understand the international picture and collaborate with their counterparts in other countries. For example, the Joint Programming Initiative on Antimicrobial Resistance ( JPIAMR ) is an international collaborative platform engaging 29 nations and the European Commission to curb AMR . JPIAMR co-ordinates national research funding and supports collaborative action for filling knowledge gaps on AMR with a One Health perspective.

A whole-systems approach to evidence generation and surveillance to resolve complex systems problems, like AMR , is necessary. The purpose of funding research on AMR is so that it can be used in practice, hence there is an ongoing commitment to strengthening the relationship between researchers and policy makers.

Case study: Health Protection Research Units - research to policy dialogue

Since 2014, NIHR has funded HPRUs dedicated to healthcare associated infections and AMR , based at the University of Oxford and Imperial College London, at a cost of £4.4 million each over 5 years. These are a partnership with UKHSA and support UKHSA ’s evidence base to enable it to deliver its strategic aims and statutory duties to protect the nation’s health.

The NIHR HPRUs fund high-quality health protection research to inform the delivery of UKHSA ’s objectives in distinct research priority areas. In addition, the HPRUs provide a flexible staff and research capacity, enabling them to respond to major or emerging health protection incidents and/or policy priorities, where appropriate, in a rapid and agile manner. They also offer advice to policy makers and analysts on the evidence base and options for policy development.

Commitment 7.2 - Research networks

We will fund and support transdisciplinary AMR networks and research and innovation grants that support the expansion of AMR communities, supporting cross-sector knowledge transfer and the delivery and implementation of timely, high impact, and independent research and innovation for AMR that meets identified needs of policy makers, practitioners, industry, civil, clinical and broader society.

The research landscape for AMR is fragmented. Communities, infrastructure and data across human, animal and plant health sectors are not well integrated and opportunities to share resources and learning are often undeveloped. ​There is an important need for innovative new tools and tactics to be developed based on a fully integrated systems-based approach. UKRI ’s transdisciplinary AMR programme works to address this via a 2-phase approach.

Phase 1 will support a broad suite of capacity building awards which will look to establish or expand existing networking opportunities in the UK AMR landscape, with phase 2 evolving into a more focused set of larger scale research grants and programmatic awards.

Outcome 8 - Health disparities and health inequalities

By 2029, the UK targets interventions and associated funding where there is the most burden from AMR , where it will have the greatest impact in controlling AMR , and where it will be cost-effective, including targeting specific regions, population groups and settings if appropriate.

This outcome has 3 commitments:

• data on health inequalities
• toolkit for addressing health inequalities
• interventions to reduce health inequalities

Good health is not spread equally in society. There are avoidable differences in health outcomes between groups or populations, and infections are no different. This plan is committed to developing understanding of the factors that affect variation in infection related health outcomes and how to address them.

It is the intention to embed the reduction of health disparities throughout delivery of this NAP , and activity focused on specific groups is not limited to this outcome. The activity and underpinning commitments are intended to demonstrate the priority of this cross-cutting area of work.

Case study: impact of infections and AMR on children and the elderly

The increased number of cases of group A streptococcus in the UK in the winter of 2022 to 2023 was a pertinent example of the way that infections affect different populations unequally, with children at particularly high risk during that surge.

Children are vulnerable to infections in general, and antibiotics are an essential tool to treating childhood illness and protecting the youngest in our society. Children are also at risk of unnecessary exposure to antibiotics, particularly for viral respiratory tract infection, and antibiotic exposure in children can adversely affect the normal development of innate and adaptive immunity, increasing susceptibility to infections in later life (see Shekhar S and Petersen FC, The dark side of antibiotics: adverse effects on the infant immune defence against infection . Frontiers in Pediatrics, 8 (2020)). Early diagnosis and prompt effective treatment of serious infection in children is critical but equally important is reducing unnecessary exposure of children to antibiotics through appropriate training and resources for prescribers, including clinical decision support tools and judicious use of diagnostic tests.

Similarly, older adults are more susceptible to AMR -related illness , likely due to incidence of infections (including healthcare-associated infections) and comorbidities. Frequent prescribing of antibiotics for older patients is widespread and there is evidence to suggest that there is frequent unnecessary prescribing in some settings, such as long-term care facilities.

Data is power when it comes to improving outcomes for the groups that need it most and our commitments below show how we will be using data to strengthen our understanding of infections and AMR in different groups, and to develop targeted interventions.

There remain large gaps in understanding and knowledge of how infection incidence, antibiotic use and clinical outcomes differ between populations. Therefore, this is an essential research priority (as set out in the top 10 under the ‘Outcome 7 - Using information for action’ section).

The PIRU evaluation of the first AMR NAP found that in addition to providing evidence-based guidelines for prescribing, consideration should also be given to local variation. This was to include geography, and population socioeconomic factors, which can affect the need for antimicrobial prescribing, especially in more deprived areas.

The ESPAUR report 2022 to 2023 showed that the AMR burden from bloodstream infections differed according to indices of multiple deprivation ( IMD ), with the rate of bloodstream infections highest in the most deprived groups (see table 2.2 in chapter 2).

Figure 7 below shows the AMR burden from bloodstream infections by IMD , where the first quintile represents the population in the most deprived 20% of areas in England and the fifth quintile represents the least deprived 20% of areas. The chart shows that the rate of bloodstream infections per 100,000 population was:

• 163.3 for IMD 1 (the most deprived group)
• 146.8 for IMD 2
• 142.8 for IMD 3
• 135.0 for IMD 4
• 125.9 for IMD 5 (the least deprived group)

Figure 7: AMR burden from bloodstream infections by deprivation

Commitment 8.1 - Data on health inequalities

We will establish pathways for collecting and reporting data annually on infection incidence, AMR and antimicrobial use, including (wherever possible) variation by age, sex, disability, ethnicity, nationality, deprivation, geography and high-risk settings, which will be used to inform intervention development.

There is excellent data available for the UK on a variety of health conditions (such as cancer and cardiovascular disease) and how they relate to protected characteristics and other categories, including ethnicity, sex and level of deprivation. While there is similar data on infections, enhancing this by committing to collecting and reporting AMR data in the context of health inequalities is essential to help inform interventions for marginalised, disadvantaged or vulnerable populations.

A targeted approach to tackling AMR is possible only by having granular enough data to know the scale of the problem at different levels and in different groups of people. Further to this, enhanced surveillance provides opportunities for more bespoke analysis of high-risk populations.

Commitment 8.2 - Toolkit for addressing health inequalities

We will collate cost-effective, evidence-based resources into a toolkit, adaptable to local needs, for identifying and addressing health inequalities in access, infection incidence, clinical outcomes, vaccine uptake and antimicrobial exposure to support organisations to develop interventions that address and do not exacerbate health inequalities.

Regional public health teams and other professionals involved in tackling AMR will benefit from a toolkit. This will ensure they are considering and addressing infection and AMR -related health disparities in their areas.

Several different groups are more vulnerable to infection and resistance, including socioeconomically disadvantaged populations, people with disabilities, migrants, refugees, children, the elderly and people living in high-risk settings. Providing support to those who need it is only possible if local government and organisations have the data and know how to address the issues identified in their areas. A toolkit for this purpose will support action at local community levels.

Research from the UK demonstrates that 10% of antibiotics in general practice are prescribed to 0.5% of registered patients, with some patients exposed to more than 10 courses of antibiotics per year (see Shallcross L and others, Antibiotic prescribing frequency amongst patients in primary care: a cohort study using electronic health records . Journal of Antimicrobial Chemotherapy, 72, 6, pages 1818 to 1824 (2017)). Work has begun to develop resources to support health professionals with the structured medication review of patients experiencing recurrent infection. This is essential to safeguard this vulnerable patient group from the threat of AMR .

Commitment 8.3 - Interventions to reduce health inequalities

We will develop, implement and evaluate interventions, underpinned by the use of health equity tools, to reduce infections and avoidable antimicrobial exposure, optimise clinical and population outcomes and patient safety, adapting approaches to consider the main groups and factors commonly associated with health inequalities.

The wider determinants of health have been well documented. The inequality observed in the outcomes from infection follow the same patterns as for non-communicable diseases, such as heart disease, mental ill health and cancer. As such, many of the interventions required, including broader, societal levers, are the same as for other health disparities.

However, there are still specific points in the patient infection pathway where there are opportunities to intervene to reduce health disparities. The commitments above will help to understand the nuance of these varied outcomes for infection and understand what specific interventions we can employ to mitigate them.

Interventions will be designed to recognise and address the different challenges that different groups, settings and localities might face. Action at a local level will be necessary to effectively mitigate the threat of AMR .

Outcome 9 - AMR diplomacy

By 2029, the UK is engaged with galvanising international action on AMR and works closely with global leaders, including through sustained engagement via the G7, G20 other multilateral groups, technical networks and bilateral relationships supporting on a clear strategy for reducing AMR risk through international research collaborations, agreed ways of measuring progress, including sharing of data and best practice.

• prevention and preparedness
• access and stewardship
• antimicrobial use in farming
• standards for manufacturing and waste management
• advocacy and engagement

AMR is a One Health global issue, respecting no borders and rendering siloed working futile. Mitigating the threat of growing AMR to global health and economic security demands international collaboration. Through work related to the first NAP as well as prior commitments, the UK is already established as an international partner in the global effort to tackle the spread of resistant infections.

International action will continue in 2 ways:

• By carrying out extensive AMR mitigation programmes in the UK through this NAP , setting a good example and sharing best practice on the international stage.
• By engagement and leadership in international multilateral and bilateral groups to:
• drive global awareness and advocacy: the UK has been instrumental in raising global awareness about AMR at the highest political level, particularly in the run up to the previous UN high-level meeting on AMR . Consistently advocating for AMR to be recognised as a major public health threat on the international stage, including prioritising it on 3 ministerial ‘tracks’ during the 2021 UK G7 presidency
• fund and foster research and innovation: the UK has invested in research and innovation to address AMR . Initiatives like GAMRIF and the UKRI cross council initiatives have provided funding for international partnerships that aim to develop new antibiotics, diagnostic tools and alternative treatments for both human and veterinary medicine. The UK’s strong pharmaceutical and research sectors also contribute to these efforts
• encourage responsible access and antimicrobial use: the UK has implemented robust policies and guidelines to promote responsible antimicrobial use in healthcare and agriculture and globally to ensure other countries do the same. Our ODA investments in research and development have been used to ensure access and stewardship requirements are built into early-stage research funding, so the next generation of products become both more accessible and better managed
• support international collaboration: the UK actively collaborates with other nations and organisations to combat AMR . Participation in international groups, such as the G7 and G20, as well as more technical forums such as the Transatlantic Task Force on AMR ( TATFAR ) and the Global Health Security Agenda to advocate for AMR mitigation and co-ordinate efforts with other leading nations
• strengthen prevention and preparedness capacity globally: the UK recognises the importance of assisting other countries to address AMR . Providing financial and technical support to build capacity for AMR surveillance, infection prevention, water and sanitation, and responsible antibiotic use programmes in these regions, including through the world’s largest single investment in AMR and antimicrobial use surveillance capability for LMICs through the Fleming Fund and Foreign, Commonwealth and Development Office (FCDO) official development assistance ( ODA )
• strengthen surveillance and reporting: the UK conducts rigorous surveillance of antibiotic resistance, contributing data to global monitoring efforts. This data helps track trends in AMR and informs international strategies for its containment

Case study: edible antibiotic alternative

A leading cause of death in LMICs , diarrhoeal disease remains a major global health problem killing around 525,000 children under 5. Globally, there are nearly 1.7 billion cases of childhood diarrhoeal disease per year, mostly resulting from contaminated food and water sources, which can lead to severe dehydration. Diarrhoeal disease is caused by a variety of bacteria, viruses and parasites which drives the use and misuse of antibiotics. While some bacterial causes of diarrhoea can be effectively treated with antibiotics, these drugs will not treat infections caused by viruses and parasites. Misuse of antibiotics can lead to the development of AMR . Sadly, many bacterial pathogens, such as Escherichia coli (E. coli) which is a leading cause of diarrhoea in LMICs , have developed resistance to commonly used antibiotics making it increasingly difficult to treat.

DHSC ’s GAMRIF tackles diarrhoeal disease in LMICs through innovative product development targeting E. coli. In partnership with the Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator, GAMRIF has funded the development of a low-cost, edible antibiotic alternative product based on the algae spirulina. This product does not need to be stored in a fridge or freezer, making it easy to ship, store and use worldwide, including in resource-poor settings.

Considering the specific needs of LMICs throughout the development of a product is vital. This enables equitable access around the world to tools that prevent and treat diarrhoeal disease and helps to slow the spread of AMR .

Commitment 9.1 - Prevention and preparedness

We will support improved global prevention of, and preparedness for, rising levels of AMR , including through building sustainable partnerships, supporting global surveillance capabilities, capacity and capability building, and system strengthening.

AMR represents a significant threat to global health security and supporting improved global prevention of and preparedness for rising levels of AMR is of critical importance. By actively contributing to global prevention efforts, the UK plays a pivotal role in reducing the risk of pandemics and health crises that have the potential to disrupt economies and overwhelm healthcare systems, both domestically and internationally.

Investing in prevention is often more cost-effective than dealing with the consequences. Preventing the emergence and spread of AMR through vaccination, responsible antibiotic use, improved infection control, access to clean water and sanitation not only saves lives but also reduces the long-term financial burden on healthcare systems. The UK has supported the development of the WHO ’s global strategy on infection prevention and control , which highlights the central role that IPC plays in mitigating AMR , as well as in responding to outbreaks and enhancing patient safety.

Sustainable partnerships are also essential in the fight against AMR . Collaborating with other nations and international organisations - such as the WHO , World Organisation for Animal Health ( WOAH ), FAO and UNEP (the Quadripartite organisations ) - strengthens the global response to AMR , enabling improved resource mobilisation and co-ordination efforts.

This commitment aligns with international agreements and agendas, including the WHO SDGs and the global action plan on AMR . It reinforces the UK commitment to these global initiatives and the UK dedication to addressing pressing global health challenges.

Robust global surveillance capabilities are crucial for early detection of drug-resistant pathogens and tracking their spread. Through the Fleming Fund, the UK improves the ability of countries to identify instances of drug resistance and monitor antimicrobial use.

Case study: the Fleming Fund

The Fleming Fund is the single largest global aid programme for AMR surveillance, supporting up to 25 countries across Asia and Africa to generate, share and use data. It builds partnerships with local governments and organisations, adopting a One Health approach across sectors. The programme invests in strengthening surveillance systems through a portfolio of country and regional grants, global projects and fellowship schemes to highlight why AMR must be a priority and give countries the tools to develop policies and actions to tackle it.

The programme supports governments to produce NAPs, using data to inform the top priorities in their countries. It also supports countries in strengthening national surveillance systems and generating and sharing high quality AMR data. On a local level, the Fleming Fund helps clinicians to improve antimicrobial stewardship and encourages sharing good practice with colleagues in their community, and even in different countries.

In phase 1 alone, the Fleming Fund has:

• produced the most comprehensive analysis of the burden of AMR ever undertaken, with the University of Oxford and Institute for Health Metrics and Evaluation ( IHME )
• supported 22,713 training attendances through regional and country grants
• supported and mentored 7,144 AMR professionals through in-country grants
• launched the UK FAO Reference Centre for AMR which provides LMICs with policy, scientific, and technical expertise
• supported over 240 laboratories across 22 countries
• funded 184 AMR Fellows from LMICs

In August 2023, the Fleming Fund announced £210 million of funding for phase 2 which will bolster the surveillance capacity in up to 25 countries where the threat and burden of  AMR  is highest with more than 250 laboratories set to be upgraded. This investment includes new genome sequencing technology which will help track bacterial transmission between humans, animals and the environment.

Commitment 9.2 - Access and stewardship

We will support equitable access to, and stewardship of, new and existing quality antimicrobials, evidence-based alternative therapeutics, vaccines and diagnostics, underpinned by internationally recognised antimicrobial classification guidelines and through more resilient and transparent supply chains, improved market access and better alignment of regulatory pathways.

Ensuring that everyone, regardless of their geographical location or socioeconomic status, has access to antimicrobials, vaccines and diagnostics is crucial for tackling AMR and achieving health equity. In LMICs , infections due to lack of antibiotics still kill more people than drug-resistant infections. Action is therefore required to ensure access to the most important first-line antibiotics. This could include advocating for tiered pricing and voluntary licensing. Access complements the main preventive measures such as water, sanitation and hygiene (WASH), IPC , vaccines and wider strategic health initiatives.

As highlighted during the COVID-19 pandemic, secure and resilient supply chains are critical to guaranteeing the availability of essential medical products. Over the next 5 years, the UK will work with partners to improve, strengthen and diversify supply chains for antimicrobials, vaccines and diagnostics, ensuring that these critical tools are accessible.

Equally, stewardship of these essential medical resources is essential to preserve their effectiveness, as described under the ‘Outcome 4 - Antimicrobial stewardship and disposal’ section. The UK supports the adoption of internationally recognised antimicrobial classification guidelines, such as the WHO ’s AWaRe categorisation and the Codex Alimentarius code of practice and guidelines . International standardisation is crucial for harmonising evidence-informed practices and reducing the risk of misuse and overuse of antimicrobials.

It is important to not undervalue existing, older antibiotics, some of which remain effective against certain infections. Using older antibiotics, when appropriate, can help preserve the effectiveness of newer antibiotics and may also be more accessible in low-resource settings.

Case study: the Access to Medicine Foundation ( ATMF )

AMR surveillance programmes are typically co-ordinated by governments and public health authorities. However, surveillance programmes can be scarce in LMICs , especially in sub-Saharan Africa.

The ATMF ’s AMR benchmark identified opportunities for large pharmaceutical companies, which collect critical data, to contribute to the fight against AMR . This data can be used by third-party researchers who cannot access government or public health authority surveillance programmes.

In partnership with the Wellcome Trust, ATMF issued a call to action in 2020 for pharmaceutical companies to share their raw data on an open-access AMR register. Heeding this call to action, several pharmaceutical companies began publicly sharing their raw data for the first time on the AMR register in June 2022, with this action attributed by some companies to the 2020 AMR benchmark. The establishment of this open-access AMR register will facilitate research and surveillance in LMICs who do not have access to government surveillance programmes.

Commitment 9.3 - Antimicrobial use in farming

We will support efforts to optimise the use of antimicrobials in farming globally.

The responsible use of antimicrobials in agriculture is essential for mitigating the development and spread of drug-resistant infections. As the interface between animals, humans and the environment, farming practices play a critical role in shaping the evolution of AMR . It is vital that we advocate for stewardship initiatives and robust animal health systems to bring into balance the excess and access issues within the animal sectors.

In the UK, the use of antibiotics as growth promoters has been banned since 2006. However, this is not the case globally, and it is thought that most of the world’s antibiotics are used in animals, which contributes to the emergence of resistance.

Advocating for responsible farming practices such as improved animal husbandry, biosecurity measures and vaccination that reduce the need for antimicrobials is paramount in addressing AMR .

Supporting international alignment of regulation is crucial for harmonising standards and ensuring that farming practices are consistent across borders. A co-ordinated approach to regulation reduces the risk of AMR spreading through the global movement of food products and livestock.

The UK supports the adoption of internationally agreed best practices, such as the Codex Alimentarius guidelines, that reinforce the importance of global standards in AMR mitigation. These guidelines represent a consensus among nations on responsible antimicrobial use in food production. The adoption ensures that farmers worldwide are following the best practices to minimise the risk of AMR development.

In other parts of the world, inadequate animal health systems and limited access to antimicrobials impacts animal health and the livelihoods of animal keepers, with 1 in 5 people globally depending on production of animals for their income and livelihoods, according to the FAO ’s The State of World Fisheries and Aquaculture 2020 .

Efforts to improve access to essential antimicrobials are vital in the context of animal health. Ensuring that farmers have access to necessary treatments while also advocating for responsible farming practices is a delicate balance. This commitment reflects the UK recognition of the need to strike this balance and aligns with its commitment to equitable access to medical resources.

The current burden of disease in animals due to AMR at the global level remains largely unknown. However, several initiatives are ongoing to estimate it, notably the Global Burden of Animal Diseases  led by WOAH and supported by the UK.

Commitment 9.4 - Standards for manufacturing and waste management

We will collaborate internationally and with industry partners to promote the development and use of global standards and certification systems for environmentally responsible antimicrobial manufacturing in human and veterinary medicines.

Applies to the environment.

The manufacturing process for antimicrobials and their raw ingredients, whether for human or veterinary use, and the management of waste generated during production, are drivers of AMR . There is therefore a critical need for responsible production practices to prevent the release of antimicrobial residues into the environment, which can contribute to the development of drug-resistant pathogens.

This could include support of standards such as the antibiotic manufacturing standard developed by the AMR Industry Alliance and the British Standards Institute ( BSI ). This standard, published in 2022, can be used to assess the impact of pharmaceuticals in the environment.

Alongside this, the AMR Industry Alliance and BSI developed an industry certification program , which launched on 6 June 2023. The BSI will act as an independent and impartial assessment body that will enable antibiotic manufacturers to demonstrate that the requirements of the antibiotic manufacturing standard have been satisfied.

The aim of the standard and certification is to serve as a mechanism for antibiotic manufacturers to show evolving good practice. It gives industry the opportunity to demonstrate its ability to self-regulate independent of government regulation.

Responsible manufacturing practices align closely with broader goals of environmental sustainability being adopted in the UK. By advocating for global standards and certification systems, the UK can contribute to the growing global effort to minimise the environmental impact of antimicrobial production, reduce the risk of AMR emergence, and protect both ecosystems and human health.

Commitment 9.5 - Advocacy and engagement

We will drive global advocacy and facilitate collaboration to address AMR by championing action at high-level international forums, strengthening global financing and accountability mechanisms, engaging in bilateral dialogues and negotiations, collaborating with civil society, and identifying and amplifying best practice internationally.

The UK is dedicated to addressing the global challenge of AMR through active diplomacy and engagement. Advocacy at high-level international groups is instrumental in raising the profile of AMR on the global political agenda and catalysing sustainable action. In the near future, this involves using the United Nations Global Assembly ( UNGA ) high-level meeting on AMR in September 2024 to secure the profile of AMR on the international agenda, foster high-level political commitment and secure ambitious, tangible commitments to combat it.

A science-led approach is critical to confronting AMR . At the UNGA high-level meeting, the UK delegation will work with other member states to establish an independent panel for evidence, as recommended by the UN Inter-Agency Coordination Group on AMR in 2019. Such an expert panel could provide member states with regular reports on the science and evidence related to AMR , its impacts and future risks, and recommend options for adaption and mitigation.

Strengthening global financing and accountability mechanisms is essential in the fight against AMR . The UK will work with partners and via multilateral groups to ensure AMR interventions have the funding they need, while promoting transparency and accountability in the use of resources. Where possible, this will happen by harnessing existing funding streams, private finance and capital investments that are already occurring in related fields such as pandemic preparedness, sustainable agriculture and health systems strengthening.

Collaborating with civil society is crucial for fostering a whole-of-society response to AMR . Civil society organisations play a vital role in raising awareness, advocating for policy changes and mobilising public support. The UK is committed to collaborating with civil society in addressing AMR , ensuring that a diverse spectrum of voices are heard.

Identifying and amplifying best practices internationally is essential for shared learning and continuous improvement. Via networks such as TATFAR , WHO networks and the Global Health Security Agenda, the UK can learn from and highlight successful approaches adopted by global partners.

Action can also be driven through engagement with the Quadripartite organisations - the WHO , WOAH , FAO and UNEP . These 4 organisations work to ensure AMR is prioritised in public health, animal health, agriculture and the environment. Through independent and joint initiatives, they drive global action on AMR . One such example is the Quadripartite Antimicrobial Resistance Multi-Stakeholder Partnership Platform . This aims to bring together all sectors and perspectives using a One Health approach, to create a shared vision responding to the need to improve co-ordination of efforts by stakeholders.

This NAP builds on progress made over the past 2 decades to strengthen our understanding of  AMR , and of what works to mitigate it. It sets out an ambitious course of action, strengthening the existing UK commitment to:

• prevent infections
• optimise the use of antimicrobials
• invest in research and innovation to address  AMR

The activity set out in this plan, combined with meaningful contributions from industry, academia and the public will help to achieve the 9 outcomes set out above. Action taken as part of this plan moves us one step closer to fulfilling the UK’s 20-year vision for  AMR .

Progress will be monitored and evaluated to maintain momentum on confronting  AMR  in a One Health way. The evidence gathered over the next 5 years, including through research, will help strengthen understanding of  AMR and lay the foundations for future work on AMR .

AMR  is a pervasive threat. The emergence of infections is relentless, while the pipeline for new antibiotics has run dry. Through this national action plan, we set out the challenge to the UK and to other countries to continue our excellent work to confront  AMR , to preserve and develop these essential medicines for generations to come and help us address one of the most pressing challenges we face this century.

Appendix A: national action plan development

The NAP has been co-developed by government organisations across the UK. It is informed by consultation with a wide range of stakeholders across sectors, including human healthcare, veterinary medicine, farming, environmental science and academia. Mitigating the threat posed by AMR requires action across all of society. In addition to the policies that governments and international organisations are developing, a willingness and engagement from many different stakeholders, including the research community, the private sector, professionals, civil societies and the general public is needed.

Taking a consultative approach was crucial to identifying and prioritising the most critical actions needed to tackle AMR over the next 5 years. In November 2022, a call for evidence on AMR was launched to inform the development of this NAP . The call for evidence gathered ideas and evidence from 200 respondents. The summary of the results of the call for evidence was published in August 2023.

Feedback gathered on the first NAP (2019 to 2024), including through the call for evidence, indicated that stakeholders outside of government found it difficult to discern government’s priorities (due to the large number of commitments) and to track progress over the 5 years. This NAP has therefore been designed to be more strategic, higher level and accessible, recognising the need to reach people outside of government.

The NAP has been developed in line with the UN IACG AMR framework for action working document (PDF, 1,710KB) . The framework identifies 3 main ways of tackling AMR (which have been adopted for this NAP , alongside the fourth theme: being a good global partner) and 15 different ‘content areas’ that describe what needs to be done. The IACG framework points to 5 ‘levers’ that describe how the content areas can be addressed and 3 ‘enablers’, describing the preconditions necessary to apply the levers successfully.

This plan aims to provide strategic direction to the work from across different government departments, public bodies and services across the UK to tackle AMR . It aligns with the roadmap on antimicrobial resistance for the WHO European region (ratified in 2023) and the WHO global action plan on AMR .

In light of learning from the first NAP , this NAP was developed in line with a ‘theory of change model’. This approach aims to balance ambition with realism about the scale of this challenge. The link between each of the outcomes and its underpinning commitments has been tested through extensive stakeholder engagement and expert review.

To reach the ambition of the outcomes over the next 5 years requires action across spheres. Spreading resources too thinly could limit our ability to achieve meaningful change. Therefore, this plan has been designed using a risk-based approach, targeting interventions where the evidence for impact is strongest. This approach includes supporting the necessary research to address the gaps where there is little evidence about which interventions work. This approach will have the highest impact and represents the best value for money. The specific activity undertaken to support each of the commitments in this NAP is subject to ongoing commitment to funding across government organisations.

Other action across sectors also has significant potential to reduce the spread of AMR . This includes actions on a systemic level such as increasing vaccination coverage, reducing overcrowding, increasing access to clean water and sanitation, and reducing pollution into waterways. There are existing government commitments (from UK government and the devolved governments) in several of these areas (for example, the Life Sciences Vision , FCDO’s International development strategy , and Defra ’s Plan for water ) and where that is the case, those commitments have not been duplicated in this document. Where appropriate, those documents have been referenced throughout this NAP .

While some activity in the NAP is specifically focused on reducing AMR (for example, IPC measures or use of antimicrobials across sectors) other measures pursue other objectives (for example, improving animal health or reducing the incidence of infectious diseases more broadly).

The 30 commitments in the NAP are underpinned by deliverables assigned and owned by delivery partners across government. A short report summarising progress made against the NAP will be published annually. Given the complexity of AMR , ensuring there are clear roles and responsibilities for all the partners involved in delivering the NAP is essential.

The NAP will be supported by a robust governance system, including monitoring and evaluation of progress. Oversight will be provided by a UK-wide, intersectoral AMR strategy board. In turn, this is informed by appropriate governance structures in England, Scotland, Wales and Northern Ireland that will ensure the delivery and monitoring of plans.

Advice will continue to be sought from expert advisers to government, including, but not limited to, the Advisory Committee on Antimicrobial Prescribing, Resistance and Healthcare Associated Infection (APRHAI) and the Advisory Committee on the Microbiological Safety of Food (ACMSF) and equivalent advisory structures in Scotland Wales and Northern Ireland. In addition, engagement with external stakeholders involved in tackling AMR can be gathered to inform government policy.

Appendix B: human health targets

The human health targets that have been included in this NAP were developed by short-term expert working groups, with representatives from across the UK. The targets have been informed by reviewing the evidence-base and learning from the measurable ambitions that were set out in the first NAP .

Each of the targets will be subject to an annual review, which will consider a range of factors to assess progress, with the potential to revise the targets if deemed appropriate and if agreed to by the UK-wide strategy board.

Target 1a: by 2029, we aim to prevent any increase in a specified set of drug-resistant infections in humans from the 2019 to 2020 financial year ( FY ) baseline.

Data will be collected from England, Scotland, Wales and Northern Ireland, with aggregate data used to generate the high-level UK metric. Data will be presented in the form of counts for the UK.

The specified set of drug-resistant infections can be found in annexe table 2.3 of the ESPAUR report 2022 to 2023: annexe .

E. coli is the causative pathogen of approximately 80% of all AMR bloodstream infections in the UK. Despite reductions in the numbers of E. coli bloodstream infection cases seen during the COVID-19 pandemic, case numbers have subsequently been rising annually. Driving down infections, the ambition of both targets 1a and 1b, should lead to reductions in prescribing and the associated risk of development of AMR .

The burden of AMR infections will be estimated using an adapted methodology developed by Cassini and others (see Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: a population-level modelling analysis . The Lancet Infectious Diseases, 19, 1, pages 56 to 66 (2018)) for a UK specific measure of AMR burden - see the ESPAUR report 2022 to 2023 .

Target 1b: by 2029, we aim to prevent any increase in Gram-negative bloodstream infections in humans from the 2019 to 2020 financial year baseline.

As for target 1a, data will be collected from England, Scotland, Wales and Northern Ireland, with aggregate data used to generate the high-level UK metric. Data will be presented in the form of counts and rates per 100,000 population for the UK.

While this target appears more conservative than the measurable ambition in the first (2019 to 2024) NAP , it has been assessed as challenging in the context of an ageing population with increasing comorbidities. The incidence of Gram-negative bloodstream infections ( GNBSIs ) is projected to increase and there is limited evidence in the literature for interventions which work to prevent GNBSIs .

Given this projected rise in incidence of GNBSIs by 2029, the target would seek to achieve a 17.2% (of 11,086) reduction in incidence, simply to remain at 2019 to 2020 levels.

Target 2a: by 2029, we aim to increase UK public and healthcare professionals’ knowledge on AMR by 10%, using 2018 and 2019 baselines, respectively.

A questionnaire-based assessment of knowledge regarding AMR will be used to assess improvements. Questionnaire data collected on healthcare professionals by a European Centre for Disease Prevention and Control ( ECDC ) project in 2019 and data collected on the public via the Eurobarometer in 2018 will be used as a baseline measure of knowledge. To measure improvements from baseline in levels of healthcare professionals’ knowledge the same knowledge questions will be repeated as part of questionnaires. For the public, questions from the Eurobarometer questionnaire can be incorporated in public surveys.

Knowledge questions from the ECDC questionnaire and Eurobarometer questionnaire will be used as a basis for surveys for healthcare professionals and public respectively.

The Eurobarometer data provides the most recent data on public knowledge attitudes and behaviours, which is representative across the UK. From Eurobarometer, UK data showed 29% of UK respondents answered all 4 questions correctly, with the overall average number of correct answers was 2.8 out of 4, compared to 43% (3.1 out of 4) for Finland and Sweden. Similarly for healthcare professionals the questionnaire conducted by ECDC in 2019 provides the most recent data for healthcare professionals across the UK. The UK data in 2019 showed that 59% of UK respondents were able to answer all 7 questions correctly. This was similar to the EU average of 58% with Croatia having the highest percentage at 73%. Data from these questionnaires will be used as a baseline with a 10% improvement in knowledge deemed achievable based on the current levels of knowledge seen and the levels of knowledge achieved within other EU countries. A 10% improvement would bring the UK in line with the highest scoring EU countries.

Although knowledge does not automatically lead to behaviour change, it’s an important first step. Including targets focused on behavioural outcomes will allow a deeper understanding of what knowledge and attitudes drive behaviour change, therefore allowing a more targeted public messaging approach for public engagement. Improving knowledge of healthcare professionals alongside increasing public knowledge is likely to be important when looking to facilitate behaviour change. Improving knowledge of both the public and healthcare workers may lead to improvements in antibiotic prescribing and consumption.

Target 4a: by 2029, we aim to reduce total antibiotic use in human populations by 5% from the 2019 baseline.

The metric for this target is defined daily doses ( DDDs ) per 1,000 inhabitants per day (DID or defined daily doses per inhabitant per day). Use of this high-level metric facilitates international benchmarking using a common definition of numerator and denominator.

A comprehensive literature review and expert consensus process, to identify optimal metrics for measuring antimicrobial consumption in hospital and outpatient settings, was conducted by the Innovative Medicines Initiative’s Driving Reinvestment in Research and Development and Responsible Antibiotic Use ( DRIVE-AB ) project. The proposed metrics align with DRIVE-AB recommendations .

The development of this target was informed by progress made and surveillance data collected during the first NAP .

Setting improvement ambitions at a UK level, such as percentage reduction targets, may not be directly applicable at regional and local settings. This is due to variation in past and current antibiotic usage levels and variation in infectious disease incidence associated with legitimate clinical demand for antimicrobials.

Target 4b: by 2029, we aim to achieve 70% of total use of antibiotics from the Access category (new UK category) across the human healthcare system.

Data will be provided by UKHSA , National Services Scotland, Public Health Wales and the Public Health Agency (Northern Ireland). Data is collected in respective prescribing and/or dispensing surveillance systems. A system is also in place to share this data to combine and form UK-level data.

The WHO ’s AWaRe categorisation for antimicrobials includes Access, Watch and Reserve categories which allows for evaluation and monitoring of use according to spectrum of activity and potential to drive resistance.

The UK has endorsed the Muscat ministerial manifesto which includes the global goal of ensuring ‘Access’ group antibiotics represent at least 60% of overall consumption in humans by 2030. The WHO has defined a target that at least 60% of human antibiotic use at the country level should be Access antibiotics. Total prescribing DDDs are being measured already.

Achieving 70% of total use of antibiotics from the new UK Access category is an ambitious task. The EU Commission recommends that, by 2030, at least 65% of the total consumption of antibiotics in humans belongs to the Access group of antibiotics ( WHO 2021 categories) in EU member states and the UK will be reporting against the UK-modified AWaRe classification which is more stringent than the WHO classification.

Budd and others (see Budd E and others, Adaptation of the WHO Essential Medicines List for national antibiotic stewardship policy in England: being AWaRe . Journal of Antimicrobial Chemotherapy, 74, 11, pages 3384 to 3389 (2019)) showed that Access antibiotics accounted for 60.9% of prescribing across all English healthcare sectors in 2016 (current UK AWaRe categories).

Appendix C: top 10 research priorities example questions

The description of the top 10 research priorities can be found in the ‘Outcome 7 - Using information for action’ section.

As the evidence base for AMR increases, there are more nuanced questions to be answered. It is critical to consider AMR in the context of other challenges, including climate change. Reducing AMR in sustainable ways that do not incur adverse unintended consequences is a priority.

The UK academic community has been a part of world-leading research on AMR . It has developed some of the most comprehensive data, surveillance and genomics capabilities in the world, which must be harnessed to underpin research and policy across sectors.

Priority setting in research is a necessary part of guiding collective policy-generation, investment in research and evaluation, implementation and delivery of actions to address AMR across sectors. The top 10 reflects a snapshot in time, showing what policy makers viewed as priorities at a particular point, inevitably influenced by the current context, wider priority agendas, and needs of the time. For this reason, the top 10 will be reviewed and updated as needed during the 5-year NAP period.

The following sub questions are intended to be an illustrative selection, rather than a comprehensive list, of the sorts of research questions which could be considered underneath each of the top 10 research priorities.

Example questions include:

• what is the economic cost of leaving AMR unchecked across the healthcare, agricultural and veterinary systems?
• how can we define the true value of a vaccine, alternative therapeutic or precision tool to reduce harm that would result from an untreatable, resistant infection?
• what are the co-benefits and trade-offs associated with the impact of different actions to tackle AMR within the agriculture sector, such as impacts on livestock productivity, crop protection, food yields and economic impacts in different animal husbandry systems?
• which socioeconomic factors (including age, sex, ethnicity, deprivation, living conditions, education, employment and so on) are associated with an increased risk of transmission, exposure, antimicrobial use, antimicrobial resistance and clinical outcomes?
• how does access to infection diagnostics differ by patient groups and what approaches should be prioritised to meet access needs?
• what works to reduce inequalities in infections, drug-resistant infections and sepsis burden across primary, secondary and community healthcare settings and how, for whom and in what situations?
• what are the current patterns of prescriber and patient knowledge, attitudes and practices relating to antibiotic prescription and use across population groups and geographic locations?
• what are the most important messages related to AMR to communicate to the public, including risks of exposure to resistant pathogens through antibiotic use and transmission risk between humans, companion animals, water and recreational activities?
• what are the most effective and cost-effective interventions to build public trust, reduce misinformation, communicate risks related to antibiotic exposure, communicate methods of self-care and reduce antibiotic seeking behaviours across population groups?
• what are the risks associated with use of antibiotics and antifungals use on crops, particularly in LMICs , and the ‘downstream’ impact on the environment, humans and animals?
• how can water and sanitation engineering solutions be developed to mitigate the environmental spread of antibiotic-resistant bacteria, considering local water treatment practices and infrastructure limitations in international settings?
• in resource-limited settings, what approaches can be employed to develop low-cost, point-of-care diagnostic tools that enable rapid and accurate identification of bacterial infections and their antibiotic resistance profiles?
• what are the other major drivers of resistance beyond the use of antimicrobials (for example, biocides, biofilms, metals, manures and slurries, sewage sludge and industrial organic wastes, chemicals, and wastewater processes in the environment)?
• how have reductions in the use of antibiotics in food-producing animals affected antibiotic resistance in people and animals?
• what is the reservoir of carriage of infectious agents and AMR in the healthy population and natural flow of resistance genes, considering a range of priority AMR pathogens, age and seasonality?
• what are the basic effects of exposure to antimicrobials, antimicrobial products and multi-purpose antimicrobials on hosts and the microbiome (human or animal), including impacts on future susceptibility to infection and sepsis?
• what is the impact of the way staff and patients move through buildings, services and the community on spread of resistant pathogens, and how can this knowledge be used to create design-led interventions to mitigate spread?
• how can effective domestic wastewater treatment, biosolid management, pharmaceutical stewardship and food waste disposal practices be used to reduce and prevent the spread of AMR in the environment in a harmonious and sustainable way?
• building and using understanding of how Gram-negative pathogens transmit in the built environment, how can we design buildings and vehicles to reduce transmission via water, air or contact surfaces (for example, environmental decontamination, ventilation, waterless systems, sinks and design of water waste systems, use of probiotic materials and antibiofilm)?
• what are the most optimal, cost-effective interventions for infection outbreak management across human healthcare settings where there is high staff turnover, competing priorities and limited resources (including long-term care facilities)?
• what is the optimal dose regimen, route of administration and duration of antibiotic therapy across antibiotics, syndromes, confirmed infections (including sepsis) and patient characteristics to maximise clinical outcomes and reduce selection of resistance?
• at what point along the healthcare pathway do diagnostic tools, including patient-led diagnostics, deliver the highest impact and return on investment, and when should they be prioritised in a resource-limited setting?
• what are the most safe and effective scenarios in which local teams (including doctors, pharmacists and dentists) can use electronic prescribing systems, ‘automatic stops,’ and clinical decision support tools to ensure risk stratification and targeted dosage of antimicrobials in different patient groups?
• when is it safe and effective to use non-pharmaceutical and/or non-antimicrobial methods at home (interventions, lifestyle factors and behaviours that is, hydration, nutrition, natural products, increased mobility, hygiene practices) to prevent common syndromes of infection, antimicrobial exposure and clinical outcomes?
• what are safe and effective alternatives to antibiotics in animals and how can farmers be supported to use non-antimicrobial medicines in agricultural practices?
• how to have culturally appropriate patient-to-healthcare professional interactions that influence patient expectations and awareness of antibiotics, risks of  AMR  and use of self-care? (These interactions would be in different settings including remote consultations, e-consults, urgent care settings, acute respiratory infection (ARI) hubs, community pharmacies and so on)
• how can we de-risk the early-stage development and evaluation of new therapeutic agents and vaccines to support their translation into clinical studies and encourage investment?
• how can we learn from and apply alternative payment models to incentivise development and implementation of new therapies, vaccines and diagnostics?
• how could we provide a framework to support the development and evaluation of a wider range of therapeutic and diagnostic modalities - including but not limited to new vaccines, antibody-based therapies, bacteriophage, host-directed therapy, microbiome modulators, biofilm disruptors and approaches that overcome resistance (for example, efflux resistance breakers, membrane permeabilities)?
• what are the enabling factors for ensuring confidence, acceptance and uptake of new products from the public and in different healthcare and veterinary settings (diagnostics, vaccines and alternative therapies for bacterial, fungal and viral infections) once they come to market?
• what are the blockers and enablers in mobilising the knowledge generated via research through to policies and practice which have an impact on reducing infections, drug-resistant infections and antimicrobial use?
• where should discovery and implementation of new products (that is, vaccines, therapies, diagnostics) take a One Health lens and where can existing products already used in one sector safely be used in another?

Appendix D: list of commitments

1.1 - informed interventions, 1.2 - the built environment, 1.3 - waste minimisation and effective waste management, 2.1 - public awareness and campaigns, 2.2 - use of educational settings, 2.3 - engagement guide, 3.1 - optimising surveillance of infections and outbreaks, and response, 3.2 - optimising surveillance to inform interventions, 4.1 - clinical decision support, 4.2 - appropriate prescribing and disposal, 4.3 - use of behavioural interventions, 5.1 - health and social care training, 5.2 - health and social care workforce, 5.3 - health and social care governance, 5.4 - veterinary workforce knowledge and skills, 5.5 - systems to support animal health, 6.1 - amr solutions, 6.2 - subscription models, 6.3 - overcoming market barriers, 6.4 - improvement and adoption, 7.1 - evidence generation and use, 7.2 - research networks, 8.1 - data on health inequalities, 8.2 - toolkit for addressing health inequalities, 8.3 - interventions to reduce health inequalities, 9.1 - prevention and preparedness, 9.2 - access and stewardship, 9.3 - antimicrobial use in farming, 9.4 - standards for manufacturing and waste management, 9.5 - advocacy and engagement, appendix e: glossary, antimicrobial.

A drug that selectively destroys or inhibits the growth of microorganisms. Examples include antibiotics (also known as antibacterials) antiviral and antifungal agents.

Antimicrobial stewardship ( AMS )

An organisational or healthcare-system-wide approach to promoting and monitoring judicious use of antimicrobials to preserve their future effectiveness.

AWaRe categorisation

A tool for monitoring antibiotic consumption, defining targets and monitoring the effects of stewardship policies that aim to optimise antibiotic use and curb antimicrobial resistance.

Bacteraemia

The presence of bacteria in the bloodstream.

Bacteriophage (phages)

A group of viruses that infect specific bacteria, usually causing their disintegration or dissolution.

Biosecurity

The prevention of disease-causing agents entering or leaving any place where they can pose a risk to farm animals, other animals, humans or the safety and quality of a food product.

Broad-spectrum antibiotics

These are drugs effective against a wide range of bacteria. For example, meropenem is a broad-spectrum antibacterial. Their use needs to be limited to resistant infections because they tend to increase the risk of resistance in other bacteria.

Codex Alimentarius guidelines

A collection of internationally recognised standards, codes of practice, guidelines, and other recommendations published by the Food and Agriculture Organization of the United Nations relating to food, food production, food labelling and food safety.

Critically important antibiotics ( CIAs )

Antibiotics identified by the World Health Organization as critically important for human health and their use needs to be restricted, especially in the veterinary sector. In the UK, we use the European Medical Agency definition of the CIAs . There are 3 classes of highest priority CIAs to which the animal industry applies restrictions.

Defined daily doses ( DDDs )

A statistical measure of drug consumption, defined by the World Health Organization Collaborating Centre for Drug Statistics Methodology, and is the average dose prescribed according to a representative sample of prescriptions.

Epidemiology

The study and analysis of the distribution, patterns and determinants of health and disease conditions in a defined population.

Eurobarometer

A collection of cross-country public opinion surveys conducted regularly on behalf of the EU Institutions since 1974.

The G20 (or Group of 20) is an international forum for the governments and central bank governors from 19 countries (Argentina, Australia, Brazil, Canada, China, France, Germany, India, Indonesia, Italy, Japan, Republic of Korea, Mexico, Russia, Saudi Arabia, South Africa, Türkiye, UK and USA) and 2 regional bodies: the EU and the African Union.

The Group of 7 (G7) is an international forum for the governments and heads of state of Canada, France, Germany, Italy, Japan, UK and USA. The EU is also represented at G7 meetings.

Gram-negative bacteria

Those bacteria that do not retain crystal violet dye in the Gram-staining procedure. They can cause many types of infection and include E. coli and Pseudomonas aeruginosa.

Gram-positive bacteria

Those bacteria that are stained dark blue or violet in the Gram-staining procedure. They include Staphylococcus aureus and Clostridium difficile.

Healthcare associated infections ( HCAIs )

Infections associated with the provision of healthcare in either a hospital or community setting.

Herd immunity

The indirect protection from an infectious disease that happens when a population is immune either through vaccination or immunity developed through previous infection.

Infection prevention and control ( IPC )

The use of safe practices and ways of working that help to prevent or reduce infections within healthcare settings.

Low and middle income countries ( LMICs )

As included at any time in the OECD Development Assistance Committee (DAC) list - a list of all countries and territories eligible to receive ODA . These consist of all low and middle income countries based on gross national income (GNI) per capita as published by the World Bank, except for G8 members, EU members and countries with a firm date for entry into the EU. The list also includes all the least developed countries (LDCs) as defined by the United Nations.

A type of bacteria that is resistant to several antibiotics.

One Health approach

Collaborative multi-disciplinary work at local, national and global levels to attain optimal health for people, animals and the environment.

Outpatient parenteral antimicrobial therapy ( OPAT )

An OPAT team manage the delivery of intravenous (into the vein or IV) antibiotics to patients who are medically stable, within their own homes.

Pandemic preparedness

The continuous process of planning, exercising, revising and translating into action national and sub-national pandemic preparedness and response plans.

An infectious agent (bug or germ), a microorganism such as a virus, bacterium or fungus that causes disease in its host.

Primary care

Services provided by GP practices, dental practices, community pharmacies and high street optometrists.

Secondary care

Covers acute healthcare, either elective care (planned specialist medical care or surgery, usually following referral) or emergency care.

Is a serious complication of an infection. Without quick treatment, sepsis can lead to multiple organ failure and death.

Sustainable development goals ( SDGs )

A set of 17 goals adopted by the United Nations in 2015 as a universal call to action to end poverty, protect the planet and ensure that by 2030 all people enjoy peace and prosperity.

Theory of change model

A model that explains how a given intervention, or set of interventions, are expected to lead to a specific development change drawing on a causal analysis based on available evidence.

A vaccine is a biological preparation that provides active acquired immunity to a particular infectious or malignant disease.

Whole genome sequencing

The process of determining the entirety, or nearly the entirety, of the DNA sequence of an organism’s genome at a single time.

Appendix F: abbreviations

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Essay on Pollution: Samples in 100, 150 and 200 Words

• Updated on  
• Apr 27, 2024

As the world embraced urbanization, mother nature witnessed the greener lands getting transformed into modern cities and metropolises. What followed is a trail of natural disasters signalling that something is wrong with the planet Earth. Pollution is increasingly asked under the writing section in school and college tests as well as competitive exams . This is because it is a relevant environmental issue today. This blog aims to help you with the necessary knowledge as well as tips and tricks to draft a well-written essay on pollution.

What is Pollution?

Pollution is the introduction of harmful materials into the environment. These materials are called pollutants. They can be created by human activity like trash and natural like volcanic ash. Pollutants damage the quality of water, air and land. Pollution is a global problem. Air and water carry pollution into the ocean currents and migrating fish. Pollution is among the many things that harm our planet- once greener and healthier than it is now. Pollution is a dangerous phenomenon that is contributing to an array of health issues.

Types of Pollution

In simple terms, pollution is defined as the contamination of the physical and biological constituents in the earth’s atmosphere. It affects human life and the natural environment to a very great extent. It degrades our natural resources, from the water we drink to the air we breathe. While writing an essay on Pollution, you must mention the major four types of pollution which are as follows:

• Air Pollution : Air pollution is the contamination of air in the atmosphere when harmful or excessive quantities of substances such as smoke and harmful gases from industries, CFCs and oxides produced by automobiles, the burning of solid wastes, etc. are introduced into the environment.
• Water Pollution : This refers to the contamination of natural resources of water, due to the addition of harmful chemical, biological or physical materials, which includes industrial wastes, oil spills, domestic and farm wastes, pesticides, as well as mining and agricultural wastes, to water resource which make it unusable.
• Soil Pollution : Land/Soil Pollution occurs due to the degradation of the earth’s surface by different commercial, industrial, agricultural and domestic activities. Causes of soil pollution also include mining, deforestation, dumping of e-waste and other industrial wastes, usage of harmful chemicals such as insecticides, pesticides, etc.
• Noise Pollution : Excess noise due to sounds created by machines, loudspeakers, microphones, loud music, noise from industries, construction and civil engineering works etc. lead to noise pollution.

Causes and Health Effects of Pollution

You can include various causes and health effects in your essay on Pollution from the following table:-

Sample Essay on Pollution in 100 Words

Pollution is the addition of unwanted substances which are incorporated into the environment that can damage our Earth. There are mainly four types of pollution, these include water pollution, air pollution, soil pollution, and noise pollution. One should note that any form of pollution is the result of careless activity carried out by man. We, humans daily dump waste directly into water bodies which leads to water pollution.

Vehicle emissions of smoke into the atmosphere impede the ability of all living things to breathe, leading to air pollution. Our garbage is dumped into landfills directly, which results in soil pollution. Although it cannot be seen, noise pollution is a severe type of pollution that can harm our ears.

Sample Essay on Pollution in 250-300 Words

The biggest threat planet Earth is facing is pollution. Unwanted substances leave a negative impact once released into an environment. There are four types of pollution air, water, land, and noise. Pollution affects the quality of life more than any human can imagine.

Due to air pollution, even teenage kids have developed various respiratory diseases. Water pollution has led to diseases in children. The waste we humans dump on the land or chemical fertilisers which are put on the land for agricultural purposes causes land/ soil pollution.

If the soil quality deteriorates due to such practices, the soil will become infertile and no crops could be grown in future. The government has launched various schemes over the years to fight pollution but individual efforts can also play a vital role.

Start by replacing plastic bags for shopping with cloth bags, stopping littering on roads and stopping wasting water are some of the basic things to start with that can lead to big changes in the environment.

Also Read: Essay on Green Energy PDF: 150 and 250 Words

Sample Essay on Pollution in 300-350 Words

One of the most critical threats faced by our planet in the present-day scenario. Environmental pollution is a global issue affecting people around the world. It is occurring in different forms, whether by affecting the air we breathe or the water resources we utilise for several purposes.

Air pollution came into being with an increase in the level of carbon dioxide, with the increase in pollutants which are contaminating the air and causing breathing discomfort as well as skin diseases to human beings. Talking about the other aspect, there is no life without water.

The water bodies are polluting and becoming unsafe for drinking or any other use because of industrial development, rapid urbanisation and various other reasons. Due to air pollution, diseases that can occur in human beings are asthma, various skin diseases, cancer, etc. Therefore, it is the essential need of the hour to take serious steps to reduce pollution to its core.

At a personal level, we can minimise environmental pollution by taking public transport or carpools to reduce vehicular smoke, avoiding firecrackers at festivals and celebrations can also cut down on air and noise pollution, and not using fertilisers and pesticides which can cause both water and soil pollution, and switching over to organic farming. The government can also bring strict rules and regulations to lessen industrial pollution.  

To sum up, any type of pollution is harmful to the environment with serious consequences like global warming, uneven climatic changes, etc. Due to our greediness and illegal human activities, the innocent lives of animals are lost. The time has come to join hands and work towards preserving and protecting the environment for the present as well as future generations.

Also Read: Essay on Environment: Examples and Tips

Short Essay on Pollution in English

Find a sample of a short essay on pollution below:

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Nikita Puri

Nikita is a creative writer and editor, who is always ready to learn new skills. She has great knowledge about study abroad universities, researching and writing blogs about them. Being a perfectionist, she has a habit of keeping her tasks complete on time before the OCD hits her. When Nikita is not busy working, you can find her eating while binge-watching The office. Also, she breathes music. She has done her bachelor's from Delhi University and her master's from Jamia Millia Islamia.

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• Biology Article
• Essay On Air Pollution 200 Words 500 Words

Essay on Air Pollution

Essay on air pollution is a crucial topic for students from an academic perspective. Moreover, an essay is one of the most effective ways to educate students about the plight of nature and the repercussions of human activities. Creating awareness for future generations is important if we have to undo decades of ignorance and neglect.

Furthermore, air pollution essay helps students to realize the gravity of the scenario and enable them to take action. Some as simple as using public transport or even carpooling will help reduce a significant amount of air pollution. Read on to discover how to write an engaging essay on air pollution.

Essay on Air Pollution – Important Points to Note

Please consider adopting the following points when writing an essay on air pollution. These tips are also helpful for other essay topics as well:

• Always begin with an introductory paragraph about the topic, preferably detailing its origin.
• Unless the topic is technical, try to avoid jargons.
• Present content in bulleted points wherever possible
• Insert factual data, such as important dates, places or name wherever possible.
• Avoid writing the content in a large monotonous block of text. Remember to break up the content into digestible chunks
• Always conclude the essay with a closing paragraph.

Essay on Air Pollution – Sample 1 (200 Words)

Air pollution is a serious issue and a cause for major concern in today’s world. A report published in 2014  by the World Health Organisation states that 4.21 million individuals died prematurely in 2012 as a result of air pollution. Air pollution existed much before humans, in the form of volcanic eruptions and forest fires. However, it became much more prevalent after the Industrial Revolution.

Rapid industrial growth, unregulated emissions and a host of other issues significantly contributed to the rise in air pollution. In some cases, the severity of air pollution reached an extent where government intervention was necessary. The Great Smog of London, 1952, was an extreme case of air pollution where visibility was severely hampered. It also caused a host of illnesses and the consequent deaths of countless civilians. In November 2017, the levels of air pollution in Delhi were ten times above the safe limits. For reference, the healthy air quality index is between 0 to 50, but during that particular time period, the air quality index hit 500+. This event is now called the Great Smog of Delhi.

An air quality index of 500 and above indicates that the air is heavily polluted and will cause irreversible lung damage and a host of other illnesses to everyone who is exposed to it. Therefore, to avoid such situations in the future, relevant actions must be implemented.

Essay on Air Pollution – Sample 2 (500 Words)

Air pollution may seem like the result of anthropological activities, however, it has been around even before humans evolved. Places which are naturally arid and have minimal vegetation are prone to dust storms. When this particulate matter is added to the air, it can cause health issues in animals exposed to the dust storms.

Furthermore, active volcanoes pump extremely large amounts of toxic plumes and particulate matter into the atmosphere. Wildfires also pump large amounts of carbon monoxide into the atmosphere and hamper photosynthesis for plants. Even animals, especially ruminants such as cows contribute to global warming by producing large quantities of methane, a greenhouse gas.

However, air pollution was never a major concern until the industrial revolution. Industries grew rapidly, untreated emissions were pumped into the atmosphere, and the rise of automobiles significantly contributed to air pollution. Such activities continued without any restrictions until they started to cause a wide range of repercussions.

In humans, air polluted with contaminants can cause a wide array of illnesses ranging from asthma and bronchitis the various forms of cancer. Air pollution is not only present outdoors; interior air pollution is also a great concern. Recent research has actually found credible evidence that room fresheners have the many compounds within them, some of which are classified carcinogens. This means some of those compounds present in the aerosol has the potential to cause some forms of cancer. Other sources of air pollution can include gases such as carbon monoxide and radon.

Radon, in particular, is quite alarming. It is an odourless, colourless gas that occurs naturally. It is found in the soil as Uranium, which breaks down and eventually turns into radon gas. Radon has limited repercussions on health if exposed to low concentrations, however, when this gas gets trapped indoor, the higher levels of concentration can have wreak havoc or ultimately be lethal. Radon is also reported to be released from building materials such as granite. Exposure to radon causes no immediate health effects, but long term exposure has the potential to cause lung cancer.

Air pollution not only affects the lungs but the central nervous system too. It has been linked to a lot of diseases such as schizophrenia and autism. A study also implied that it can cause short-term memory losses or distortion of memory.

Historically, air pollution has caused many crises with the worst ever being the Bhopal Disaster in 1984. Fatalities were estimated at 3,800, with at least 600,000 injured. Next in severity was the Great Smog of 1952 which formed over London, killing an estimated 4,000 civilians over the course of four days.

Though measures have been taken to reduce the effects of air pollution, a lot of irreversible damage has been done. For instance, the effects of global warming have drastically increased; this is very apparent with the rise in sea levels and melting glaciers. If the ice caps continue to melt, then we will have to face drastic repercussions. Scientists have proposed a hypothetical scenario where the greenhouse effect becomes “uncontrolled.” Here, greenhouse gases build up and temperatures continue to rise steeply. Oceans will start to evaporate, adding more water vapour into the earth’s atmosphere. This intensifies the effect, reaching a point where temperatures are sufficiently high for rocks start sublimating. Though this scenario is hypothetical, some speculate that this phenomenon already occurred on Venus. The supporters of this theory back this up by claiming Venus has an atmosphere composed primarily of carbon dioxide. The theory also explains why Venus has an extremely high surface temperature of 462 degrees Celcius; which is in fact, the hottest planet in the solar system.

Hence, we need to reduce our impact on the planet and make a conscious effort to reduce air pollution. Explore more essay topics or other fascinating concepts by registering at BYJU’S

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Environmental Pollution Essay

Pollution is the presence and inclusion of unwanted items in the environment. The state of the environment is altered when it has become contaminated with potentially dangerous compounds as a result of human activity. Water, air, and land are dangerously affected by the pollution. Here are a few sample essays on environmental pollution:

100 Words Essay on Environmental Pollution

200 words essay on environmental pollution, 500 words essay on environmental pollution.

When it comes to protecting the environment, awareness is the key. As more and more people become aware of the causes, types, and impacts of environmental pollution, they are more likely to take steps to prevent it. Air pollution is created as a result of burning fossil fuels, such as coal, oil, and natural gas. Water pollution results from industrial activities, such as the dumping of chemicals into rivers and lakes, as well as from agricultural runoff. Land pollution is caused by the misuse of land and improper disposal of waste. The causes of environmental pollution are numerous and varied. Some of the main culprits are industrial activities, burning of fossil fuels, use of pesticides, and deforestation.

Awareness and taking necessary resolving steps is essential when it comes to protecting the environment from the impacts of environmental pollution. By teaching people the importance of taking steps to prevent environmental pollution, we can ensure a brighter future for our planet. We must understand the causes of environmental pollution, the types of pollution, the impact it has on the environment, and how we can prevent it.

Causes | Environmental pollution is the contamination of the environment through the emissions of pollutants including harmful gases, chemicals, and particulate matter. It is caused by human activities such as burning of fossil fuels, deforestation, and industrial pollution. These activities have caused global warming, acid rain, and water and air pollution, leading to global environmental degradation.

Types | There are different types of environmental pollution. The most common type is air pollution, which is caused by burning of fuels and other industrial activities. Water pollution is another common type of pollution which is caused by sewage and industrial waste. Soil pollution is caused by overuse of pesticides and other chemicals. Noise pollution is caused by traffic, construction activities, and industrial noise. Light pollution is caused by the emission of artificial light.

Impact | The impact of environmental pollution is far-reaching and devastating. Air pollution can lead to respiratory diseases, while water pollution can contaminate drinking water and cause health issues. Land pollution causes reduction in soil fertility and even destruction of natural habitats for animals. In addition, it can lead to the destruction of ecosystems, which in turn leads to a decrease in biodiversity.

Environmental pollution has serious impacts on both humans and the environment. It affects air quality, water quality, soil fertility, and public health. Poor air quality affects the respiratory system, leading to respiratory illnesses like asthma and bronchitis. Water pollution can lead to the spread of diseases like cholera, typhoid, and dysentery. Soil pollution can reduce crop yields, leading to food insecurity.

Types of Environmental Pollution

Air | Air pollution is the introduction of dangerous compounds into the atmosphere, which has a negative influence on the environment and humanity. Air pollution simply makes the air impure or contaminated. It happens when noxious gases, scents, dust, or fumes are discharged into the air in concentrations that endanger human and animal comfort or health or even kill plant life.

Water | The act of contaminating water bodies, such as rivers, oceans, lakes, streams, aquifers, and groundwater, is known as water pollution. It happens when foreign, dangerous substances—such as chemicals, garbage, or polluted materials are released into bodies of water, either directly or indirectly.

Land | When the quality of the earth's land surfaces in terms of use, landscape, and capacity to support life forms is compromised or destroyed, this is referred to as land pollution. It is frequently brought on by human activity and the misuse of land resources, both directly and indirectly.

Soil | Chemical pollutants can pollute soil or cause it to degrade through activities like mining, clearing vegetation, or topsoil erosion. Typically, it occurs when human activities bring harmful chemicals, substances, or items into the soil.

Noise | Noise pollution is an unpleasant sound or a sound that causes excruciating ear pain. Noise pollution is described as unpleasant and unwanted sound levels that cause significant distress to all living beings. It is measured in decibels (dB).

Factors Responsible For Environmental Pollution

Environmental pollution has a variety of causes. One of the most prominent is the burning of fossil fuels, such as coal, oil and gas by power plants, factories and automobiles. This produces large amounts of carbon dioxide, which is a major contributor to global climate change. Other sources of environmental pollution include agricultural practices, such as over-fertilization and the use of pesticides, and industrial processes, such as mining, manufacturing and waste disposal.

What Can We Do

To prevent environmental pollution, we must reduce the emissions of various pollutants. We can do this by switching to renewable sources of energy like solar, wind, and hydroelectric power. We should reduce our reliance on fossil fuels and use more efficient transportation methods. We should also reduce the emissions of harmful industrial chemicals and practise sustainable agriculture. Additionally, we should increase public awareness of environmental pollution and its impacts, and promote eco-friendly lifestyles.

By understanding the causes and effects of environmental pollution, we can work towards preventing it and ensuring a cleaner, healthier environment for all. Awarness and knowledge is essential in this regard, as it helps us to become more conscious and informed citizens. It helps us understand the importance of protecting and preserving the environment and make us more responsible citizens.

The world is facing an ever-growing threat from pollution, which if left unchecked will have catastrophic consequences. Education and taking conscious action plan can play a key role in helping to reduce environmental pollution.

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Essay on Pollution in 150, 250, 500 Words- Types, Effects, How to Reduce

Essay on Pollution in 150, 250, 500 Words – Students of almost each class get an assignment or homework to write an essay on pollution. The word limit can be 150, 250 or 500 depending upon the class they study. Students from class 1 to 12 can take help of this short essay about pollution taking important points. Take help from this short essay on pollution in English to complete their homework on time. To help students, we have provided a pollution essay in 150, 250, 500 Words. Instead of using the exact words, students are suggested to modify the word and include more thoughts to make the essay on pollution more enticing. With the help of a well-phrased pollution essay, students will be able to get good marks in their final exams. Also read- Essay on Mahatma Gandhi

Essay on Pollution in 500 Words

Pollution is the presence of harmful substances in the environment. These harmful substances are called pollutants. There are various types of pollution that are Air Pollution, Water Pollution, Noise pollution and more. Because of the increase in population, pollution is also increasing on a daily basis. People are getting hazardous diseases with the increased level of pollution. Hence, everyone should be aware of the pollution, its effects and how to reduce it effectively. Also read- Essay on My School

What is Pollution?

Like a balanced diet for a healthy body, our environment also needs every substance in a balanced proportion. If any substance increases more than its threshold amount then it pollutes the environment such as increased carbon dioxide, Nitrogen oxides in the atmosphere pollutes the air and adversely affects the health of humans. Also Read- Essay on Diwali

Types of Pollution

There are different types of pollution that affect different sections of the environment.

• Air Pollution
• Water Pollution
• Noise Pollution
• Soil Pollution
• Environment Pollution

Effects of Pollution

Due to the pollution, people and the environment are getting affected in different ways. Here are some of the most recognised bad impacts of pollution.

• People exposed to high levels of noise pollution face hearing problems, high blood pressure, sleep disturbance and other issues.
• Because of the high level of air pollution, Global warming is increasing which will further depleting the ozone layer. Besides, breathing problems are increasing in humans.
• Many species of animals and birds are at the verge of extinction such as sparrow which are almost extinct.
• Increased water pollution is destroying life underwater. 
• Pesticides used in crops are increasing the risk of cancer and other dangerous diseases. Continuous increase of soil pollution is making the soil infertile.

How to Reduce Pollution?

People should join hands to reduce pollution. So that our coming generations can experience the healthy environment. To preserve the healthy living environment, people should take some precautions and measures. Check the below steps that can help in reducing the pollutants-

• Reduce the use of non-biodegradable things – Environment has a property of reviving itself by degrading the naturally produced substances. However, the non- biodegradable things like plastic bags and bottles pollute the environment.
• Plant more trees – To decrease the air pollution and save the species, it is very important to plant more number of trees. Trees help in purifying the air by adding more oxygen in the environment.
• Less Use of Chemicals – With advancement in technology, many chemical-made substances are used to improve the yield of food products. People should produce food without using pesticides and 
• Reduce Population – Continuously increasing population is the major reason for increased pollution. People should follow the policy We two, our two (hum do hamare do) to keep the population under control.
• Recycling is also a very effective and efficient way to reduce the pollution. It helps in limiting the use of non- biodegradable products.

Essay on Pollution in 250 words for Class 5 Students

Pollution is referred as the presence of harmful substance in the environment. It impact on every person, animal or lining creature on this earth. These unwanted substances added in the environment also known as pollutant. These pollutant creates various diseases and often lead to death of the living creature. There are different types of pollution, and each one has its own problems.

• Air Pollution: When pollutant or harmful elements are present in air is called Air Pollution. Air pollution is formed from smoke and gases from cars and factories get into the air we breathe. It can make our air dirty and cause us to get sick with coughs and other bad things.
• Water Pollution: When factories dump dirty water into rivers or lakes, it makes the water dirty and not safe to drink. This hurts the fish and other animals living in the water too.
• Soil Pollution: Sometimes, chemicals from things like trash and pesticides get into the soil. This makes it hard for plants to grow and can even make our food unsafe to eat.
• Noise Pollution: Have you ever heard loud sounds that bother you? That’s noise pollution! It comes from things like cars honking, machines at work, and even loud music. It can make it hard for animals to hear and cause people to feel stressed.
• Light Pollution : At night, when there are too many lights on, it can confuse animals that need darkness. Even we humans need dark nights to sleep well!

Pollution is a big problem, but we can help stop it! We can do things like using less energy, recycling our trash, and not wasting water. Governments and scientists are also working on ways to make cleaner technologies and laws to protect our environment.

Remember, we all share this beautiful planet, so let’s work together to keep it clean and safe for everyone! By learning about pollution and taking small steps to help, we can make a big difference and have a happy, healthy world for us and future generations.

Short Essay on Pollution

Pollution is a pressing global issue that threatens the health of our planet and its inhabitants. It refers to the introduction of harmful substances or contaminants into the environment, leading to adverse effects on air, water, soil, and living organisms.

Air pollution is one of the most significant forms of pollution, caused by emissions from vehicles, industries, and burning of fossil fuels. These pollutants, such as carbon monoxide, sulfur dioxide, and particulate matter, contribute to respiratory diseases, smog, and climate change.

Water pollution occurs when harmful substances are discharged into rivers, lakes, and oceans, contaminating drinking water sources and harming aquatic life. Industrial waste, agricultural runoff, and improper disposal of sewage are major contributors to water pollution.

Soil pollution, often caused by industrial activities, mining, and improper waste disposal, degrades soil quality and affects agricultural productivity. Contaminants like heavy metals, pesticides, and chemicals can accumulate in the soil, posing risks to human health and the environment.

Pollution not only harms the environment but also impacts human health, leading to respiratory illnesses, cardiovascular diseases, and cancer. It also disrupts ecosystems, causing biodiversity loss and ecological imbalance.

Addressing pollution requires collective action at local, national, and global levels. Implementing stricter regulations, adopting cleaner technologies, promoting renewable energy sources, and raising public awareness are crucial steps in mitigating pollution and safeguarding the planet for future generations. It’s imperative that we take urgent and concerted efforts to combat pollution and protect the health and well-being of all living beings on Earth.

Essay on Pollution in 150 words

Pollution is a significant environmental issue that affects our planet and its inhabitants. It occurs when harmful substances or contaminants are introduced into the environment, leading to adverse effects on air, water, soil, and living organisms.

One of the most prevalent forms of pollution is air pollution, caused by emissions from vehicles, industries, and burning of fossil fuels. These pollutants include carbon monoxide, sulfur dioxide, and particulate matter, which can cause respiratory illnesses, smog, and climate change.

Water pollution is another pressing concern, resulting from the discharge of pollutants into rivers, lakes, and oceans. Industrial waste, agricultural runoff, and improper sewage disposal contaminate water sources, endangering aquatic life and compromising human health.

Soil pollution, caused by industrial activities and improper waste disposal, degrades soil quality and affects agricultural productivity.

Pollution poses serious health risks to humans and wildlife, disrupts ecosystems, and threatens biodiversity. To combat pollution, it’s essential to adopt sustainable practices, reduce emissions, and promote environmental conservation efforts. Only by working together can we mitigate pollution and safeguard the health of our planet for future generations.

10 Lines of Pollution

• Pollution is the introduction of harmful substances or contaminants into the environment.
• It can take various forms, including air pollution, water pollution, and soil pollution.
• Air pollution is caused by emissions from vehicles, industries, and burning of fossil fuels.
• Water pollution occurs due to the discharge of pollutants into rivers, lakes, and oceans.
• Soil pollution results from industrial activities, mining, and improper waste disposal.
• Pollution poses serious health risks to humans, including respiratory diseases and cancer.
• It also harms wildlife and ecosystems, leading to biodiversity loss and habitat destruction.
• Plastic pollution, caused by the accumulation of plastic waste, is a major concern in oceans and water bodies.
• Pollution is exacerbated by unsustainable practices and overconsumption of natural resources.
• Addressing pollution requires collective action and sustainable solutions to protect the environment and human health.

Essay on Pollution- How to Write Effectively?

While writing an essay on Pollution, students should keep a few tips in mind to get good marks.

• Always highlight the important facts or information so that the teacher can get the highlights at one glance. This will improve the readability of the essay on pollution. 
• Make sure you write essays in pointers to make it easier to read. If the essay is of 10 marks then do not forget to add 10 unique lines in points. This will help in getting good scores in the essay writing section.
• Students can use some facts and quotes to support their statement that will give some extra points in board exams.

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261 Pollution Essay Topics & Essay Examples

The problem of environmental pollution is one of the main subjects for discussion worldwide. Manufacturing, carbon emissions, plastic, etc., have an adverse impact on air, water, and soil entire the world. That is why it is crucial to understand the problem and develop solutions to mitigate our negative effects on Earth.

In this article, you will find interesting research questions about pollution, ideas for your argumentative and persuasive papers, and essay examples to inspire.

Keep reading!

💡 8 Tips for Writing Essays on Pollution

🏆 best pollution topic ideas & essay examples, 🥇 captivating pollution research topics, 🌩️ shocking pollution essay examples and topic ideas, 🎓 simple & easy topics related to pollution, ✅ most interesting pollution topics to write about, ✍️ pollution essay topics for college, ❓ research questions about pollution.

There is a rising interest in ecological awareness and an overall building desire to move towards sustainable living within society. Thus, a pollution essay requires much more than merely outlining cause and effect occurrences.

Tackling a topic that should be both conscientious and demanding may be a difficult task, but with these few tips below, you can quickly address all pollution essay topics. Here are some ideas on how to make your assigned essay more comfortable to write:

Do your research beforehand. This action will help you start your bibliography, which you should begin by writing down every book and article you hope to use.

Additionally, doing so will help you better understand your subject and be more comfortable writing about it. Readers can always feel when writers are too vague because they want to avoid some aspects of a problem.

Introduce your issue from a historical viewpoint. You should explain the origin of your problem, outlining what changes began affecting the environment and why.

Doing so not only allows engaging your readers but also prevents needlessly confusing them by being evasive about your subject.

If some key terms and processes are not common knowledge, then you should explain them. Topics on pollution have tricky terminology, and you should allow your readers to read your essay while on the same level of knowledge as you.

For example, if you are writing about air pollution, then the terms you use may range from “particulate matter” to “hygroscopicity,” depending on the complexity of your essay’s subject.

The pollution essay thesis statement is a guiding line throughout your writing process. Every sentence you write should relate to your central argument and help advance it forward.

From when you start outlining until you write your conclusion and even when revising your draft, you should always ask yourself whether your writing helps you uphold your thesis.

Use credible sources to support your writing. Book and journal titles, research papers, and even interviews with respected scientists are good examples of what you should include in a bibliography.

You may also use pollution essay quotations to demonstrate scientists’ opinions or statistical numbers. When you reference your facts, your readers trust your writing and accept it as credible and truthful, as well as show a good understanding of the subject.

Give your essay an appropriate heading. Your pollution essay titles should clue your readers in on your argument. Using a “talking” title, which explains your subject at a glance, is a useful way of making your essay stand out among others.

If your subject ties together different issues, then you should think about using subheadings to make your essay more readable.

For example, when writing about nonpoint source pollution, you may need to mention its effects on both ocean and forest environments.

Doing so in different sections of your essay may help you structure your thoughts and bring together your arguments for a well-written conclusion.

Read sample essays written by others to help you understand your subject and essay structure better. Doing so will help you be consistent with your chosen citation style and immerse yourself in your research.

However, do not commit an academic offense by plagiarizing from the work of others.

Need more tips? Want to read an essay example? Visit IvyPanda!

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• Cultural Pollution:Traditions and Historical Concepts The cultures traditions and historical concepts of the Middle East have over the centuries been characterised as by a distinct sense of variety that stems from a whirlwind of customs and traditions.
• Environmental Pollution: Causes and Solutions The consequences that have risen as a result of neglecting to take care of the environment have now become a reality to the whole of mankind.
• Environmental Pollution and Its Effect on Health In climate change, due to air pollution, the main force to prevent environmental disasters need to change the approach to the production of substances from fossil fuels.
• Water Pollution in the Philippines: Metropolitan Manila Area In this brief economic analysis of water pollution in Metro Manila, it is proposed to look at the industrial use of waters and the household use to understand the impact that the population growth and […]
• Air Travel as a Cause of Severe Pollution Ecologists cite the growth of air travel as one of the factors that are contributing to environmental pollution. Restricting air transport can minimize the amount of noise that airplanes make, therefore improving the quality of […]
• Coca-Cola India and Water Pollution Issues The first difficulty that the representatives of the Coca-Cola Company happened to face due to their campaign in the territory of India was caused by the concerns of the local government.
• The Ocean Pollution Problem Overview Ocean pollution is the unfavorable upshot due to the entrance of chemicals and particulate substances into the ocean. The land is the key source of ocean pollution in the form of non-point water pollution.
• Environmental Pollution: Causes and Consequences The essay will provide an overview of pollution and proffer solutions to combating pollution for a sustainable environment and health. Preventing pollution lowers the cost to the environment and the economy.
• Pollution as a Big Problem That Faces the World Pollution is human made, pausing devastating health issues among the community at large, and its management cuts across all spectrums of societies including cultural, political, ethnic, and educational backgrounds Various forms of pollution have contributed […]
• Nurse Associate’s Role in Air Pollution Prevention This paper analyzes current health promotion strategies in Somerset and the United Kingdom, obstacles to preventative health strategies, health screening programs, the impact of psycho-social, economic, and behavioral factors, epidemiology and genomics, vaccination and immunization […]
• Car Air Pollution Further, NO2 can prevent the flow of oxygen in the blood to other parts of the body like the brain. These toxic substances settle in the lungs and disrupt the normal flow of air in […]
• Air Pollution and Its Impact on Human Health Community needs assessment is a systematic process in which the health educator, the nurse and other health care professionals together with the members of the community determine the health problems & needs of the community […]
• Acid Rain and Ozone Pollution Acid rain and ozone pollution are a form of pollution, which entails the release of gaseous and dust particles in quantities that destroy the integrity of the atmosphere and affect organisms in their respective habitats […]
• Hudson River Pollution Concerns Unfortunately, the Industrial Revolution and the subsequent advancement of the local and national economy have turned the River into an object of environmental pollution.
• The World Oceans Pollution and Overfishing Human beings have taken a lot of time to realize the need for ocean conservation to the extent that the ocean has succumbed to ecological challenges that have affected their lives in a variety of […]
• Plastic Pollution From a Sociological Standpoint Wagner, as well as Miranda and de Carvalho-Souza, are in favor of increased recycling efforts to prevent more plastic from escaping into the sea.
• Integrated Pollution Prevention and Control Environmental management is dynamic and it is concurrent to the existing management strategies and agenda of the company. Statutes and legislations pertaining to environmental compliance enforce the need to implement environmental management and monitoring of […]
• Environmental Pollution in the Petroleum Industry At the same time, it threatens nature and creates many long-term issues related to pollution of air, soil, water, the weakening of the ozone layer, and the facilitation of the greenhouse gas effect.
• New York City Air Pollution Problem One positive impact of technological advancements on the environment in New York is the ability to provide communication options that are friendly to the environment.
• Air Pollution Impacts on Weather and Climate Air pollution is rated to be the major cause of discomfort in the living creatures of the world for air is essential for the survival of every living creature.
• The Problem of Ocean Pollution in Modern World Wastes such as toxic matter, plastics, and human wastes are some of the major sources of pollution in the ocean. Many people consume fish as food; when marine life is affected by toxic substance in […]
• Smog, Its Harm and Pollution Reduction Progress Smog can be defined as the mixture of solid and liquid fog and smoke particles that are formed under the impact of high humidity and calm air.
• Air Pollution in Beijing and Its Effects on Society It is worth noting that different regions/countries/cities in the world have different levels of air pollution depending on the intensity/presence of causing agents and the techniques applied in dealing with air pollution.
• Cashion Water Quality: Spatial Distribution of Water Pollution Incidents This essay discusses the quality of water as per the report of 2021 obtained from the municipality, the quality issue and the source of pollution, and how the pollution impacts human health and the environment […]
• Environmental Factors and Health Promotion: Indoor and Outdoor Air Pollution This presentation offers some information about the damage of air pollution and presents a health promotion plan with helpful resources and evidence from research.
• Noise and Sound Pollution The noise pollution should be considered by the duration of the sound, the frequency of noise, and whether there is any control to the sound or not.
• Water Pollution: OIL Spills Aspects The effects of the oil spill on a species of ducks called the Harlequin ducks were formulated and the author attempted to trace out the immediate and residual effects of the oil on the birds.
• Technological Applications in Industrial Pollution Prevention I also understand that pollution prevention emerged from the need to protect the environment from degradation and that appropriate regulations require manufacturers to put in place measures to prevent the release of dangerous emissions.
• Pollution and Neglect in America During his stay in Ohio, he is realizing an increase in challenges, which he attributes to neglect by the members of the society.
• The Effects of Noise Pollution Noise pollution meaning When speaking about the effects of noise pollution, it is necessary to highlight some fundamentals of the issue.
• Environmental Pollution and Increased Birds Death The increase in the population of different animals may also cause the death of birds. This leads to the extinction of some animals and birds hence massive death.
• Smog and Air Pollution in Los Angeles The city is often covered with a yellow veil in the sky, so the problem of smog is an actual problem of the state.
• Graveyard Ship Pollution in Kuwait The main legal issue of this case is the collision of two ships that led to the killing of millions of people and the dumping of waste along the sea.
• Environmental Pollution and Human Health The effects of sprawl on health workers are discussed in the article by Pohanka. It is similarly essential to take social justice and fairness into account because the effects of sprawl on population health are […]
• The Ecogeographical Impact of Air Pollution The weakness of the text is that the safety of NPs and their probable toxic effects on human health and the environment are not evaluated.
• Water Pollution as a Crime Against the Environment In particular, water pollution is a widespread crime against the environment, even though it is a severe felony that can result in harm to many people and vast territories.
• Carbon Offsets: Combatting Environmental Pollution I think that using other organizations or projects to offset an entity’s carbon footprint avoids the main goal of any present environmental protection efforts sustainability.
• Environmental Pollution: Waste Landfilling and Open Dumping The solution is simple and practical it is necessary to put efforts into further development of hard industries and stop financing the research of the issue that is useless.
• Air Pollution and Impact of Transportation Emissions of greenhouse gases, air pollution, the release of ballast water, aquatic invasive species, and oil and chemical leaks are only some of the environmental problems that marine transportation continues to cause.
• Pollution and Respiratory Disease in Louisiana The United States of America is an industrial powerhouse, a powerful nation that devoted much of its time to the growth and development of the petrochemical industry.
• Beat Plastic Pollution Essay These tips will help people to reduce the circulation of plastic in their lives. In conclusion, the best method to protect the environment is to minimize the accumulation of plastic waste by recycling, composting, and […]
• Air Pollution and Lung Disease To design a study in order to explore the link between lung disease and air pollution, it would be possible to follow a four-step process started by identifying the level or unit of analysis.
• American Society on Health and Pollution’s Activity The organization is purposed to inspire newly elected leaders to act as examples and lead the way in the promotion of a green economy that is sustainable for all American citizens.
• Environmental Justice: Pollution However, the issue of environmental racism transcends national boundaries and is likely to be repeated in other regions of the world.
• Air Pollution in China: Atmospheric Chemistry and Physics One of the most acute environmental problems in China is air pollution, which the authorities are trying to solve, but still, many people, factories, and active processes of globalization do not allow environmental programs to […]
• CSR Initiatives in Reducing Pollution and Carbon Emissions in GCC The purpose of this paper is to conduct a literature review evaluating the impact of CSR initiatives in reducing pollution and carbon emissions in GCC and the Middle East.
• The Negative Impact of Soil Pollution The picture does not show where the water is coming from, and that is how to determine whether the pollution is from a non-point source.
• Algae Explosion and Nitrogen Pollution in Lakes One of the most problematic aspects of nitrogen pollution as a form of nutrient pollution in lakes is the algae explosion.
• A Pollution Concern in the Anacostia River In addition, the unending sedimentation affected the river’s ecosystem due to the lack of sunshine, especially at the bottom of the river.
• Air Pollution and Child Health Conducting research, leading scholars, and summarizing the results of their efforts allowed the organization to investigate the numerous ways air pollution damages the human body.
• Environmental Protection: Pollution and Fossil Fuels The term used to describe a combination of oil and petroleum-related businesses, fossil fuel has been continuously cited as being dangerous for the planet.
• Importance of Mercury Water Pollution Problem Solutions The severity of the mercury contamination consequences depends on the age of the person exposed to the contamination, the way of contamination, the health condition, and many other factors.
• Issue of Pollution of Everest A policy that can be put in place by Nepal to address the current state of pollution on Everest is limiting the number of climbers to the mountain. The increase in the number of people […]
• The Impact of Atmospheric Pollution on Human Health and the Environment Atmospheric pollution is a set of environmental problems associated with releasing chemicals and accumulating concentrations of natural gases in the air.
• Air Pollution and Vulnerability to Covid-19 In other words, the findings will be used as one of the key arguments for showing that air pollution is detrimental to both individual and societal health.
• Poor Waste Disposal and Pollution in California For instance, the rapid increase in the number of factories and industries in California has led to more waste products in the state.
• Technical Report Pollution in Cities of Trinidad Many people who live in the environment close to the dumping sites are exposed to the daily combustion of the refuse, coupled with the inhalation of the emissions from the combusted material.
• Cultural Pollution in the Middle East The importance of the cultural patriarchal society suffers the whims of the feminist movement that has underscored the cultural values and roles of women.
• Fundamentals of Air Pollution The components of secondary air pollution include ozone and nitrogen oxides. Smog occurs when “car exhausts are exposed to direct sunlight”.
• The Reduction of Agricultural Nutrient Pollution: Possible Solutions The nutrients that are contained in fertilizer or manure may reach water basins and cause a dramatic increase in the populations of phytoplankton and algae.
• The Perspectives of Pollution for International Business Turning to the society’s role in changing the unsustainable system, the most important part of the discussion is usually dedicated to the role-changing possibility in the governmental structure.
• Pollution Problem: Sewage Spills in San Jose Water is a crucial element for all known forms of life to be able to live. Groundwater quality is essential for human consumption and social and economic activities.
• Equipment to Monitor Pollution Emissions In assessing the situation, the vital aspects are: the quality of the decision, the commitment of the subordinates, the knowledge of the leader, the structure of the problem, the probability of subordinates’ commitment, sharing the […]
• Global Plastic Pollution Problem and Its Drivers The primary challenge is the production and use of plastic products, which overwhelm the environment’s capacity to withstand. It cannot be burned because of air contamination, and the process of recycling equally results in plastic […]
• Plastic Pollution and Its Consequences Water in vapor form is also a product of combusted carbon-rich molecules and forms part of the hydrosphere from where it is absorbed into the biosphere.
• Newark Water Crisis: Water Pollution Problem The main problem was rooted in the fact that lead levels in the drinking water were highly elevated, which is dangerous and detrimental to the population’s health.
• Pollution Caused by Plastic Materials However, it is important to note that regardless of the many pleasant and appealing uses of plastics, the numerous health problems and dangers presented to the environment are gruesome.
• Pollution and Illegal Dumping in Chilliwack River Chilliwack River Watershed maintenance is under great pressure because of differing use of resources and activity, high demands for growth and recreation, and impacts to quality of water and riparian habitation from different water-use and […]
• Simply Green Products Firm: Pollution Allegations The natural decomposition is the surety that the company to the environmentalist organizations and the citizens. There is considerable proof that the company has been the primary producer of the packaging materials for the orchards […]
• Atmospheric Pollution Constituents A department dealing with the effects of atmospheric pollutants in the vicinity of an industrial complex has established a data table of measurements of a purity index Y on a scale of 0 to 1000 […]
• Air Pollution: The Problem’ Review Indoor pollution and related conditions are a big burden to the already suffering world according to the reports of the world health organization that it’s the 8th most important risk factor and is perceived to […]
• Law, Property Rights, and Air Pollution In the law of torts, ‘harm’ is considered when there is physical invasion to a person there fore in the case there was no violation of this law as the secretary was not harmed by […]
• Reducing Traffic Noise Pollution in Cairo In conclusion, it seems reasonable to state that the issue of traffic noise pollution is rapidly growing in Egypt’s capital Cairo and increasingly impacts public health.
• Air Pollution in Middle East: Saudi Arabia The rate of air pollution in the world has increased gradually since the advent of the industrial revolution in the early 1800s.
• Global Pollution and Climate Change Both of these works address the topic of Global pollution, Global warming, and Climate change, which are relevant to the current situation in the world.
• Health Science: Pollution and Health The spill was apparently a result of the containing dam wall being weak and the ensuing heavy rains rapidly increased the volume of the contents resulting in breaking of the reservoir.
• Point vs. Non-Point Air Pollution To determine the air pollution source of a large smoke stack, one has to assess the physical characteristics of the smoke; description of the color concentration intensity is it grey or extremely dark?
• Noise Pollution: Best Practicable Means Magistrates’ Court identified Statutory Nuisance in the case and forwarded an abatement order against respondents along with a huge fine for their misconduct that led to noise pollution.
• Public Policy Issue: Particle Pollution in Chicago Metropolitan Area The Chicago metropolitan area has been mentioned quite a number of times in American Lung Association’s State of the Air 2008, an annual report that grades the quality of the air across the different cities […]
• Noise Pollution: Environmental Issue in Lagos, Nigeria The aim of the study would be to understand and evaluate the amount of noise pollution in Lagos, Nigeria and its affects on public health.
• Air Pollution and Health Issues in the US The industry of health care is closely connected to the industrial activities sector, which has the largest impact on the atmosphere through polluting the air, soil, and waters.
• Thames Water Company’s Pollution Issue and Ecocentrism Fines can be treated as a strong solution to this issue even though it is not presupposed by the ethical theory discussed, as they ensure that some funds can be spent on protecting the environment.
• Air Pollution Externalities and Possible Solutions In order to fully integrate public utility, power generation, policy and use of nuclear power in light of the growing concerns on the depletion of natural forms of energy as well as degradation of the […]
• Industrial Pollution in China and USA The pollution of world’s environment with industrial wastes is highly intensified and according to the authors’ opinion the scientific approach is the most significant and useful tool for the purpose of quick resolving of this […]
• Air Pollution and Ecological Perspectives of the Atmosphere The major contributors to CO2, one of the main pollutants in the atmosphere, are the burning of fossil fuels and deforestation.
• Pollution Is a Consistent Demolition of the Earth Pollution means the introduction into the environment of substances or energy that is liable to cause hazards to human health, harm to living resources and ecological systems, damage to structure or interfere with the legitimate […]
• Air Pollution and Its World History From the times of industrial revolution, smoke pollution was a concern and continues to be one with vehicles and industries replacing coal and wood.
• Water Pollution in a Community: Mitigation Plan Though for the fact that planet earth is abundant with water and almost two-thirds of the planet is made up of water still it is viewed that in future years, a shortage of water may […]
• The Influence of Global Warming and Pollution on the Environment This essay is going to address global warming from a psychological point of view with an emphasis on the psychological and social reasons that make it important to tackle this problem which is threatening the […]
• Atmospheric Chemistry – Pollution Ozone, a photochemical pollutant, is formed by the oxidation of explosive organic compounds in the presence of sunlight and oxides of nitrogen in the atmosphere.
• Construction Technology and Air Pollution Hot-list section has new and transferable technology and highlights the features that appeal to construction companies, specifies and designers, owners of the building and end users.
• As China Roars, Pollution Reaches Deadly Extremes The idea is to harness the excess waters of the Yangtze River to replenish the Yellow River which perennially suffers from lack of water and the formation of silt.
• Pollution Control Policy: Glodal Issues Global warming poses a great problem for the global biosphere since it affects the habitat of most of the natural occupants of the global hemisphere.
• Earth’s Atmosphere and Natural Pollution The stratosphere is the next layer of the atmosphere and is from that 7 17 km range to about 30 km above the earth’s surface.
• Atmospheric Pollution and Global Warming Green forests help in soaking the suspended particles in the air and thus clean the air for all of us to breathe.
• Recurrent Pollution of the Tisza River of Hungary The Tisza basin is located almost precisely in the geographical center of Europe and crosses the near-future boundary of the European Union.
• Marine Pollution: Management and International Legislation Marine environment refers to: the physical, chemical, geological and biological components, conditions and factors which interact and determine the productivity of, state, condition and quality of the marine ecosystem, the waters of the seas and […]
• Marine Pollution: Sources, Types, Pathways, and Status By examining sources, types, pathways, and status of water contamination in the context of the World Ocean, it is clear that most marine pollution caused by human actions, especially the mismanagement of plastic debris.
• The Public Perceptions of Air Pollution and Related Policies in London The primary questions for consideration are the public perceptions of air pollution and related policies in London and other cities of the United Kingdom, previous surveys regarding existing policies related to the environment or air […]
• Concerns of Ocean Ecosystem Pollution The range of adverse outcomes for ocean ecosystems can be discussed in volumes; however, the current discussion will focus on trash in the ocean waters, acidification, and the disruption of the marine life cycles.
• Food Distribution and Water Pollution Therefore, food distribution is one of the central reasons for water pollution. According to Greenpeace, one of the ways to improve the ecology of the planet is by creating healthy food markets.
• How China Cuts Its Air Pollution 5, which is the smallest and one of the most harmful polluting particles, were 54 percent lower in the last quarter of 2017 as compared to the same period in 2016, specifically in Beijing.
• Haze Pollution in China One of the outstanding aspects of pollution in the country is that the Chinese are highly desensitized and aware of issues surrounding this matter.
• Pollution and Federal Environmental Policy Pollution continues to influence the flora and the fauna of the United States, as well as people in urban and even rural areas.
• Plastic Pollution and Social Institutions The purpose of this paper is to investigate the political and economic barriers that hamper the efforts to reduce plastic pollution and discuss the ways in how they could be overcome.
• Social Activism Against Plastic Pollution Of the 30 million tons of plastic waste in the United States in 2009, only 7% were sent for recycling, which primarily damages marine life.
• Climate Change: Reducing Industrial Air Pollution One of the most effective measures of air quality in the USA is the Air Quality Index, which estimates air conditions by concentrations of such pollutants as particle solution, nitrogen and sulfur dioxide, carbon monoxide, […]
• Pollution as a Social Issue and Mass Media’s Role The reason why plastic pollution gained traction only during the 21st century is directly connected to the invention of the Internet and the technological advances in electronics.
• Environmental Ethics. Optimal Pollution: Reality or Myth? The effects of globalization and environmental change have caused the resurgence of environmentalism, yet the necessity to sustain industries and the global economy invalidates the idea of a pollution-free environment.
• Environmental Pollution and Contamination The rains are known to corrode marble and metals, cause respiratory diseases in human beings and increase the acidity of the soil.
• Low Pollution Car Engine The following is a discussion on the introduction of the low pollution car engine and its benefits to the UAE. In addition, pollution and climate change will be a thing of the past.
• Chemistry: Environmental Pollution in Hungary The acidification of water bodies leads to the death of numerous species that are susceptible to the presence of acid. Part of the problem is caused by the fact that Hungary is currently forced to […]
• Environmental Pollution Analysis The author explains that the damaging alterations have become possible due to the use of a large number of pesticides in the area.
• Coal Pollution in China as an Environmental Problem Thesis: Coal pollution in China has been a significant cause of environmental pollution-China being one of the largest coal producers in the world- therefore, necessitating the development of appropriate measures to reduce its severity.
• Air Pollution, Its Constituents and Health Effects The National Ambient Air Quality Standards are the regulations or policies that are adopted by states to ensure the safety of the environment.
• The Deepwater Horizon Oil Platform Pollution The oil spillage in the sea can result to the death of sea animals as well as plants that thrive in the water because of the dangerous chemicals that are contained in the oil.
• Air Pollution in the United Arab Emirates’ Cities In the article called Evaluating the Potential Impact of Global Warming on the UAE Residential Buildings, the author focuses on the negative consequences of global warming on the situation in the United Arab Emirates.
• Advanced Pollution Prevention in the United States In the United States, the overview of the previous legislation shows that the government used to enforce measures that would deal with pollution control which occurred at the final stage of production processes. The Pollution […]
• Climate Change, Air Pollution, Soil Degradation Then followed by outdoor air pollution, soil degradation which can also be called as soil contamination, global overpopulation, drinking water pollution, nuclear waste build-up, disappearing of the water supplies, indoor air pollution, depletion of the […]
• China Shenhua Energy Company: Pollution Reducing Although the Chinese government recognized the issue of pollution and announced a course for liberalization of the economy and a greater emphasis on ecology during the 12th 5-year plan, the transformation from a coal-based energy […]
• Air Pollution in Washington State and Healthy Living of People The problem of air pollution is closely related to the issue of the energy supply of the US. Due to the high level of air pollution in Washington state, there is a growing threat to […]
• Air Pollution as a Factor for Renal Cancer Therefore, to prevent renal cancer, it is crucial to examine the primary causes and look for better strategies to curb the issue.
• Podocnemis Lewyana: Habitat Loss, Overfishing and Pollution The second factor is overhunting, which in the case of Magdalena River Turtle leads to the inability of these animals to locate food.
• Pollution in the San Francisco Bay The rivers provide fresh water for domestic use to many civilians, and it is apparent that the authorities have given the power plant the freedom to test the quantity of chemicals in the waste water.
• Indoor Air Pollution: The Silent Killer in Rural India The video “Indoor air pollution: The silent killer” discusses the detrimental impact of indoor air pollution in rural Indian households on people’s health. The problem of indoor air pollution is rather significant, and people should […]
• Water Pollution and Associated Health Risks The results of plenty of studies indicate the existence of the relation between the contamination of water by hazardous chemicals and the development of respiratory and cardiovascular diseases, cancer, asthma, allergies, as well as reproductive […]
• Air Pollution and China’s Governmental Measures The consequences of air pollution in China are already becoming evident, and not only they are the reason for environmental problems, but also they have a significant influence on the health of Chinese people living […]
• Lake Erie Water Pollution There are worries among the members of the community that the lake could be facing another episode of high toxicity, and they have called for the authorities to investigate the main causes of the pollution […]
• Environmental Pollution and Green Policies Although various scholars are of the view that green technology reduces the level of pollution, adequate research on the use of this form of technology needs to be conducted so as to fully contain environmental […]
• Air Pollution in Beijing and the Decision-Making Bias Severe air pollution in Beijing did not become a subject of worldwide concern and discussion until the 2008 Beijing Olympics, which brought the issue to the attention of the global public due to the immense […]
• “Fort McMurray Fires Cause Air Pollution” by McDiarmid As a rule, the air in Canada is clean and rich in oxygen; however, when the wildfire burst, it affected the ozone layer to a significant degree.
• Air Pollution as the Trigger of the Ecological Catastrophe The key data collection tool is a survey that is targeted at determining the main factors of air pollution, finding out the social opinion regarding the quality of air in different cities, and estimating the […]
• Agricultural Nutrient Pollution and Its Reduction The solutions that have been proposed for the issue are varied: there is the possibility of upgrading farms with the help of better technologies, controlling the use of fertilizers and waste discharge with the help […]
• Water & Air Pollution and Health Issues in Brazil The main environmental effects of pollution include the destruction of marine habitats, water scarcity, and anoxia. The conclusion is informative because the writer includes strategies to alleviate the problem of air and water pollution in […]
• Air Pollution and Respiratory Illnesses in Nigeria The purpose of the article presented was to test the relationship of the respiratory system illness and air pollution in developing countries, especially in Africa.
• Air Pollution Impact on Children’s Health in the US In these parts of the country, the level of air pollution is much higher. Nevertheless, the growing number of vehicles in the United States contributes to air pollution.
• Traffic-Related Air Pollution and Health Effects It emphasizes the fact that air contamination has a negative influence on the health of the representatives of the general public.
• Nebraska Pollution Prevention Project The article is about Nebraska’s Partners in Pollution Prevention program and the benefits it has brought to the state in the reduction of pollution caused by small businesses.
• Storm Water Pollution Prevention Plan All players need to be trained in significant areas of business so as they can handle them with care and beware of the potential they have in causing damage.
• Water Pollution in the US: Causes and Control Although water pollution can hardly be ceased entirely, the current rates of water pollution can be reduced by resorting to the sustainable principle of water use in both the industrial area and the realm of […]
• Economic View on Water and Pollution Some of the water is found in the continents’ rivers, lakes and in the subsurface. This research tries to explain the importance of water especially in an economist’s perspective by explaining the uses of water […]
• Air Pollution in Los Angeles The escalation of congestion in the city has worsened the problem of air pollution because of the volume of unhealthy air emitted in the atmosphere.
• Noise Pollution: Urban Traffic Noise Besides these two, noise also has an effect on the learning of an individual so that it distracts the individual in a way that s/he is not able to learn, as would be the case […]
• Environmental Revolution: Air Pollution in China
• Pollution & Climate Change as Environmental Risks
• The Knoxville City’s Environmental Pollution
• Aviation’s Environmental Impact and Pollution
• Environmental Behavior and Air Pollution in Ohio
• Water Pollution and Management in the UAE
• Pollution of the Ganges and Its Main Factors
• Pollution Externalities Role in Management Economics
• Marine Pollution and the Anthropogenic Effects Upon It
• The New York City Air Pollution
• Air Pollution Effects on the Health and Environment
• Dealing With Air Pollution
• Environmental Justice and Air Pollution in Canada
• Environment Destruction: Pollution
• Big Coal and the Natural Environment Pollution
• Principles of Air Pollution Control and Analysis
• China’s Air Pollution Problem
• Pollution and Human Health
• Business and Pollution Inequality in Poor States
• China’s Air Pollution Is Not Unique
• Water Pollution and Its Challenges
• An Investigation of Green Roofs to Mitigate Air Pollution With Special Reference to Tehran, Iran
• Air Pollution: Human Influence on Environment
• Kuwait’s Desert Pollution
• Water Pollution Sources, Effects and Control
• Issues in Non-Point Source Pollution
• Air Pollution Sources in Houston
• Pollution Prevention in the Industrial Production
• Pollution Caused by Medium-Sized Enterprises and the Means to Prevent It
• Air Pollution: Public Health Impact
• Solutions to the Los Angeles Metropolitan Watershed Pollution Problem
• Economic Impact of Industrial Pollution in China
• Environmental Impacts of Air Pollution
• Pollution in Beijing, China
• Nitrate and Phosphate Pollution of Freshwater Ecosystem: Sources, Impacts and Cost Effective Measurements
• Automobile Pollution in the US
• Chloramine in Drinking Water: When the Threat of Pollution Emerges
• How Mechanical Engineering Used to Prevent and Fix Oil Pollution
• Technologies for Reduction of Automobile Pollution
• “Water and Pollution” Class Game
• How Bad Pollution Is in the Arab World
• Water in Crisis: Public Health Concerns in Africa
• Does Air Pollution in Schools Influence Student Performance?
• Regulation and Management of Haze Pollution in Canada
• Air Pollution Characteristics and Effect
• Impact of Blowing Drums on Air Pollution
• The System for Pollution Offsets
• The Nature of Nonpoint Pollution Control Problem
• Air and Water Pollution
• Health Hazard of Noise Pollution
• Fossil Fuels Subsidies and the Impact of Pollution on Health and Lifetime Earnings
• Causes of Water Pollution and the Present Environmental Solution
• Water Pollution & Diseases (Undeveloped Nations)
• Environmental Pollution in Canada
• The Impact of Industrial Pollution on the Environment
• Water and Water Pollution in Point of Economics’ View
• Air Pollution Sources, Effects and Ways of Minimizing
• Environmental Justice Issues Affecting African Americans: Water Pollution
• Plastic Ocean Pollution on Ocean Life in U.S.
• Air Pollution Effects on the Health in China
• Air Pollution and Health Policy in China
• The Pollution Within: Foreign Substances in the Human Body
• Air Pollution and Its Consequences
• The Problem of Atmospheric Pollution in Modern World
• Four Marketing Practices That Cause Noise Pollution
• Water Pollution and Wind Energy
• Air Pollution by Automobiles
• Air and Water Pollution in Los Angeles
• Tehran Chokes and Blames Severe Pollution on US Sanctions
• Water Pollution Causes and Climate Impacts
• The Case of PBC Pollution in Hudson River
• Preposition 23: Suspension of Air Pollution Control Act
• Climate and Air Pollution
• Urban Pollution – Many Long Years Ago
• Water Pollution Origins and Ways of Resolving
• Can Pollution Rights Trading Effectively Control Environmental Problems?
• Mud Lick Creek Project – Fresh Water Pollution
• A Discussion of Air Pollution & Related Health Implications on the Community
• Car Pollution in Moscow
• What Causes Air Pollution and What Effect Does It Have on People?
• Why Air Pollution Can Harm the Environment Dramatically?
• What Are the Sources of Air Pollution?
• Does Air Pollution Affect Health and Medical Insurance Cost in the Elderly?
• What Are the Causes and Effects of Water Pollution in Lake Huron?
• What Causes Water Pollution and Its Effects?
• What Can the Public Do to Curb Pollution?
• Will COVID-19 Containment and Treatment Measures Drive Shifts in Marine Litter Pollution?
• Does Inequality Matter Air Pollution and Health Relationship?
• Why Environmental Management May Yield No-Regret Pollution Abatement Options?
• How Can Be Organised Curbing Environmental Pollution Through Recycling?
• What Will the Effects Be if We Don’t Stop Plastic Pollution in Our Oceans?
• Does Air Pollution Crowd Out Foreign Direct Investment Inflows?
• Does Off-Farm Employment Contribute to Agriculture-Based Environmental Pollution?
• Does Environmental Pollution Affect Metropolitan Housing Prices?
• Does Financial Instability Increase Environmental Pollution in Pakistan?
• What Are the Leading Factors of Water Pollution Around the World?
• What King of Cost-Effective Control Strategies for Energy-Related Transboundary Air Pollution in Western Europe?
• Which Firms Are More Sensitive to Public Disclosure Schemes for Pollution Control?
• What Are the Kinds of Water Pollution?
• Does Air Pollution Affect Consumption Behavior?
• What Are the Causes and Effects of Water Pollution?
• Does Animal Feeding Operation Pollution Hurt Public Health?
• Does Industry Self-Regulation Reduce Pollution?
• Will Pollution Free Cars Become a Reality of the Near Future?
• Who Pays for Industrial Pollution Abatement?
• Does Trade Promote Environmental Coordination of Pollution in International Rivers?
• Who Suffers From Indoor Air Pollution?
• What Are the Main Ways to Reduce Pollution?
• What Causes Haze Pollution?
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IvyPanda . 2024. "261 Pollution Essay Topics & Essay Examples." March 2, 2024. https://ivypanda.com/essays/topic/pollution-essay-examples/.

1. IvyPanda . "261 Pollution Essay Topics & Essay Examples." March 2, 2024. https://ivypanda.com/essays/topic/pollution-essay-examples/.

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IvyPanda . "261 Pollution Essay Topics & Essay Examples." March 2, 2024. https://ivypanda.com/essays/topic/pollution-essay-examples/.

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ENCYCLOPEDIC ENTRY

Air pollution.

Air pollution consists of chemicals or particles in the air that can harm the health of humans, animals, and plants. It also damages buildings.

Biology, Ecology, Earth Science, Geography

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Air pollution consists of chemicals or particles in the air that can harm the health of humans, animals, and plants. It also damages buildings. Pollutants in the air take many forms. They can be gases , solid particles, or liquid droplets. Sources of Air Pollution Pollution enters the Earth's atmosphere in many different ways. Most air pollution is created by people, taking the form of emissions from factories, cars, planes, or aerosol cans . Second-hand cigarette smoke is also considered air pollution. These man-made sources of pollution are called anthropogenic sources . Some types of air pollution, such as smoke from wildfires or ash from volcanoes , occur naturally. These are called natural sources . Air pollution is most common in large cities where emissions from many different sources are concentrated . Sometimes, mountains or tall buildings prevent air pollution from spreading out. This air pollution often appears as a cloud making the air murky. It is called smog . The word "smog" comes from combining the words "smoke" and " fog ." Large cities in poor and developing nations tend to have more air pollution than cities in developed nations. According to the World Health Organization (WHO) , some of the worlds most polluted cities are Karachi, Pakistan; New Delhi, India; Beijing, China; Lima, Peru; and Cairo, Egypt. However, many developed nations also have air pollution problems. Los Angeles, California, is nicknamed Smog City. Indoor Air Pollution Air pollution is usually thought of as smoke from large factories or exhaust from vehicles. But there are many types of indoor air pollution as well. Heating a house by burning substances such as kerosene , wood, and coal can contaminate the air inside the house. Ash and smoke make breathing difficult, and they can stick to walls, food, and clothing. Naturally-occurring radon gas, a cancer -causing material, can also build up in homes. Radon is released through the surface of the Earth. Inexpensive systems installed by professionals can reduce radon levels. Some construction materials, including insulation , are also dangerous to people's health. In addition, ventilation , or air movement, in homes and rooms can lead to the spread of toxic mold . A single colony of mold may exist in a damp, cool place in a house, such as between walls. The mold's spores enter the air and spread throughout the house. People can become sick from breathing in the spores. Effects On Humans People experience a wide range of health effects from being exposed to air pollution. Effects can be broken down into short-term effects and long-term effects . Short-term effects, which are temporary , include illnesses such as pneumonia or bronchitis . They also include discomfort such as irritation to the nose, throat, eyes, or skin. Air pollution can also cause headaches, dizziness, and nausea . Bad smells made by factories, garbage , or sewer systems are considered air pollution, too. These odors are less serious but still unpleasant . Long-term effects of air pollution can last for years or for an entire lifetime. They can even lead to a person's death. Long-term health effects from air pollution include heart disease , lung cancer, and respiratory diseases such as emphysema . Air pollution can also cause long-term damage to people's nerves , brain, kidneys , liver , and other organs. Some scientists suspect air pollutants cause birth defects . Nearly 2.5 million people die worldwide each year from the effects of outdoor or indoor air pollution. People react differently to different types of air pollution. Young children and older adults, whose immune systems tend to be weaker, are often more sensitive to pollution. Conditions such as asthma , heart disease, and lung disease can be made worse by exposure to air pollution. The length of exposure and amount and type of pollutants are also factors. Effects On The Environment Like people, animals, and plants, entire ecosystems can suffer effects from air pollution. Haze , like smog, is a visible type of air pollution that obscures shapes and colors. Hazy air pollution can even muffle sounds. Air pollution particles eventually fall back to Earth. Air pollution can directly contaminate the surface of bodies of water and soil . This can kill crops or reduce their yield . It can kill young trees and other plants. Sulfur dioxide and nitrogen oxide particles in the air, can create acid rain when they mix with water and oxygen in the atmosphere. These air pollutants come mostly from coal-fired power plants and motor vehicles . When acid rain falls to Earth, it damages plants by changing soil composition ; degrades water quality in rivers, lakes and streams; damages crops; and can cause buildings and monuments to decay . Like humans, animals can suffer health effects from exposure to air pollution. Birth defects, diseases, and lower reproductive rates have all been attributed to air pollution. Global Warming Global warming is an environmental phenomenon caused by natural and anthropogenic air pollution. It refers to rising air and ocean temperatures around the world. This temperature rise is at least partially caused by an increase in the amount of greenhouse gases in the atmosphere. Greenhouse gases trap heat energy in the Earths atmosphere. (Usually, more of Earths heat escapes into space.) Carbon dioxide is a greenhouse gas that has had the biggest effect on global warming. Carbon dioxide is emitted into the atmosphere by burning fossil fuels (coal, gasoline , and natural gas ). Humans have come to rely on fossil fuels to power cars and planes, heat homes, and run factories. Doing these things pollutes the air with carbon dioxide. Other greenhouse gases emitted by natural and artificial sources also include methane , nitrous oxide , and fluorinated gases. Methane is a major emission from coal plants and agricultural processes. Nitrous oxide is a common emission from industrial factories, agriculture, and the burning of fossil fuels in cars. Fluorinated gases, such as hydrofluorocarbons , are emitted by industry. Fluorinated gases are often used instead of gases such as chlorofluorocarbons (CFCs). CFCs have been outlawed in many places because they deplete the ozone layer . Worldwide, many countries have taken steps to reduce or limit greenhouse gas emissions to combat global warming. The Kyoto Protocol , first adopted in Kyoto, Japan, in 1997, is an agreement between 183 countries that they will work to reduce their carbon dioxide emissions. The United States has not signed that treaty . Regulation In addition to the international Kyoto Protocol, most developed nations have adopted laws to regulate emissions and reduce air pollution. In the United States, debate is under way about a system called cap and trade to limit emissions. This system would cap, or place a limit, on the amount of pollution a company is allowed. Companies that exceeded their cap would have to pay. Companies that polluted less than their cap could trade or sell their remaining pollution allowance to other companies. Cap and trade would essentially pay companies to limit pollution. In 2006 the World Health Organization issued new Air Quality Guidelines. The WHOs guidelines are tougher than most individual countries existing guidelines. The WHO guidelines aim to reduce air pollution-related deaths by 15 percent a year. Reduction Anybody can take steps to reduce air pollution. Millions of people every day make simple changes in their lives to do this. Taking public transportation instead of driving a car, or riding a bike instead of traveling in carbon dioxide-emitting vehicles are a couple of ways to reduce air pollution. Avoiding aerosol cans, recycling yard trimmings instead of burning them, and not smoking cigarettes are others.

Downwinders The United States conducted tests of nuclear weapons at the Nevada Test Site in southern Nevada in the 1950s. These tests sent invisible radioactive particles into the atmosphere. These air pollution particles traveled with wind currents, eventually falling to Earth, sometimes hundreds of miles away in states including Idaho, Utah, Arizona, and Washington. These areas were considered to be "downwind" from the Nevada Test Site. Decades later, people living in those downwind areascalled "downwinders"began developing cancer at above-normal rates. In 1990, the U.S. government passed the Radiation Exposure Compensation Act. This law entitles some downwinders to payments of $50,000.

Greenhouse Gases There are five major greenhouse gases in Earth's atmosphere.

• water vapor
• carbon dioxide
• nitrous oxide

London Smog What has come to be known as the London Smog of 1952, or the Great Smog of 1952, was a four-day incident that sickened 100,000 people and caused as many as 12,000 deaths. Very cold weather in December 1952 led residents of London, England, to burn more coal to keep warm. Smoke and other pollutants became trapped by a thick fog that settled over the city. The polluted fog became so thick that people could only see a few meters in front of them.

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Related Resources

Plastic Pollution Essay for Students and Children

500+ words essay on plastic pollution.

Plastic is everywhere nowadays. People are using it endlessly just for their comfort. However, no one realizes how it is harming our planet. We need to become aware of the consequences so that we can stop plastic pollution . Kids should be taught from their childhood to avoid using plastic. Similarly, adults must check each other on the same. In addition, the government must take stringent measures to stop plastic pollution before it gets too late.

Uprise of Plastic Pollution

Plastic has become one of the most used substances. It is seen everywhere these days, from supermarkets to common households. Why is that? Why is the use of plastic on the rise instead of diminishing? The main reason is that plastic is very cheap. It costs lesser than other alternatives like paper and cloth. This is why it is so common.

Secondly, it is very easy to use. Plastic can be used for almost anything either liquid or solid. Moreover, it comes in different forms which we can easily mold.

Furthermore, we see that plastic is a non-biodegradable material. It does not leave the face of the Earth . We cannot dissolve plastic in land or water, it remains forever. Thus, more and more use of plastic means more plastic which won’t get dissolved. Thus, the uprise of plastic pollution is happening at a very rapid rate.

Get the huge list of more than 500 Essay Topics and Ideas

Impact of Plastic Pollution

Plastic Pollution is affecting the whole earth, including mankind, wildlife, and aquatic life. It is spreading like a disease which has no cure. We all must realize the harmful impact it has on our lives so as to avert it as soon as possible.

Plastic pollutes our water. Each year, tonnes of plastic are dumped into the ocean. As plastic does not dissolve, it remains in the water thereby hampering its purity. This means we won’t be left with clean water in the coming years.

Furthermore, plastic pollutes our land as well. When humans dump Plastic waste into landfills, the soil gets damaged. It ruins the fertility of the soil. In addition to this, various disease-carrying insects collect in that area, causing deadly illnesses.

Should Plastic Be Banned? Read the Essay here

Most importantly, plastic pollution harms the Marine life . The plastic litter in the water is mistaken for food by the aquatic animals. They eat it and die eventually. For instance, a dolphin died due to a plastic ring stuck in its mouth. It couldn’t open its mouth due to that and died of starvation. Thus, we see how innocent animals are dying because of plastic pollution.

In short, we see how plastic pollution is ruining everyone’s life on earth. We must take major steps to prevent it. We must use alternatives like cloth bags and paper bags instead of plastic bags. If we are purchasing plastic, we must reuse it. We must avoid drinking bottled water which contributes largely to plastic pollution. The government must put a plastic ban on the use of plastic. All this can prevent plastic pollution to a large extent.

FAQs on Plastic Pollution Essay

Q.1 Why is plastic pollution on the rise?

A.1 Plastic Pollution is on the rise because nowadays people are using plastic endlessly. It is very economical and easily available. Moreover, plastic does not dissolve in the land or water, it stays for more than hundred years contributing to uprise of plastic pollution.

Q.2 How is plastic pollution impacting the earth?

A.2 Plastic pollution is impacting the earth in various ways. Firstly, it is polluting our water. This causes a shortage of clean water and thus we cannot have enough supply for all. Moreover, it is also ruining our soils and lands. The soil fertility is depleting and disease-carrying insects are collecting in landfills of plastic.

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• Pollution and Its Effects Essay

Essay on Pollution and Its Effects

The term pollution is ubiquitous these days, even among children. The fact that pollution is rising continuously has become so prevalent that almost everyone acknowledges it. In pollution, we mean a substance that has been introduced uninvited into something. Various pollutants are contaminating the earth's natural resources when we talk about pollution. These effects are mainly caused by human activities that harm the environment in a number of ways. As a result, it is vital that this problem is addressed immediately. We need to recognize the effects of pollution and prevent its harm to our earth, which means we need to prevent these devastating effects. Here, we will look at what pollution is, how it occurs, and what we can do about it.

The Effects of Pollution

It is impossible to imagine how much pollution affects one's quality of life. The process occurs in mysterious ways, sometimes unobservable to the naked eye. Despite its enigmatic nature, it is profoundly present in the surrounding environment. Natural gases are present in the air even though you may not see them. Similar to the pollutants that are polluting the air and increasing carbon dioxide levels, pollutants pose a great threat to humans. Global warming is a consequence of increasing levels of carbon dioxide.

Additionally, the water will be polluted due to industrial development, religious practices and other practices leading to a shortage of drinking water. The need for water is essential to our existence. A waste dump that ends up in the soil eventually becomes toxic because of the way it is disposed of. In the future, we will no longer have fertile soil to grow crops on if the rate of land pollution continues. We must take immediate steps to reduce the level of land pollution.

What are the Best Ways to Reduce Pollution?

It is important to take action as soon as possible to prevent or reduce pollution after learning of the harmful effects of pollution. Taking public transportation or carpooling reduces vehicle emissions, hence reducing air pollution. Aside from reducing air and noise pollution, avoiding firecrackers at festivals and celebrations may also reduce air pollution. Recycling is essential to reducing air pollution in general. It pollutes the oceans and land when used plastic ends up in them.

After using these utensils, be sure to reuse them as long as you can, rather than throw them away after using them. As well as encouraging everyone to plant more trees, which absorb harmful gases and clean the air, we need to encourage everyone to plant more trees. At a national level, the government should limit fertilizer use to ensure the nutrient content of the soil. Further, pollution of oceans and rivers must be dealt with by preventing industries from dumping their waste into them.

The bottom line is that all pollutant types are hazardous and have serious consequences. Whether it is a personal initiative or an industry-wide initiative, everyone must take steps to change. It is necessary to join forces now since solving this problem will require a collective effort. Additionally, such human actions are causing the deaths of innocent animals. We must all take a stand and speak out for those who cannot speak for themselves in order to protect this planet from pollution. 

Short Essay 

The pollution problem in the world today is one of the most disturbing. We will talk about the extent of these effects and their harmful effects in this short paper on pollution and its effects in English. In this essay on pollution and its effects, the author aims to eradicate pollution from the earth. In this essay on pollution and its causes, we will discuss our responsibilities as citizens. The next generation has to learn how to fight pollution with proper equipment while reducing waste. 

Planting trees and taking care of our environment will help us prevent pollution levels from rising. The oil spills in the sea can be checked, and industrial wastes dumping into the water can be stopped to prevent pollution of the marine environment. To combat pollution and how serious its effects can be, we should not only take steps but also teach our children to do the same. 

Types of Pollution

  Air Pollution

Water Pollution

   Soil Pollution

The following paragraph provides some information about the effects of pollution on the environment which can help us to take measures against it to protect life on earth for future generations. In order to eradicate pollution and make the world a greener place, we must all take these steps. 

FAQs on Pollution and Its Effects Essay

1. What are the impacts of Air Pollution?

Elevated levels of air contamination can cause an expanded danger of coronary failure, wheezing, hacking, and breathing issues, and bothering of the eyes, nose, and throat. Air contamination can likewise cause declining in existing heart issues, asthma, and other lung confusions. Like people, creatures can experience the ill effects of various medical conditions because of air contamination, including birth abandons, regenerative disappointment, and illnesses. Corrosive downpour contains significant levels of nitric and sulfuric acids that are made by oxides and sulfur oxides delivered into the air by the consumption of non-renewable energy sources.

2. What are the effects of Water Pollution?

The impacts of water contamination rely upon which synthetics are being unloaded where. Waterways that are close to urbanized zones will, in general, be vigorously dirtied by dumbing of trash and synthetic compounds, both lawfully and illicitly, by modern plants, wellbeing focuses, and people. By a long shot, the greatest outcome of water contamination is the demise of amphibian animals, which can upset the whole natural way of life. Poisons, for example, cadmium, mercury, and lead are eaten by little oceanic life forms that are then eaten by fish and shellfish, getting more thought with each progression up the natural pecking order and causing major issues in people and untamed life. 

3. What are the effects of pollution?

Humans are affected by pollution on a daily basis. The air we breathe and almost every form of water we drink is degraded by it. Environmental degradation contributes to illness.

4. What can be done to reduce pollution?

To reduce pollution, each of us must take action. They should plant more trees, and they should decompose their waste more mindfully. Furthermore, it is a good idea to recycle where possible and make the environment cleaner.

5. How does water pollution affect us?

Depending on the type of synthetics being dumped where water contamination impacts are different. Those waterways near urbanized zones will, in general, be heavily polluted by humans, modern plants, and wellbeing centers, as well as by trash dumps and synthetic compounds lawfully and illegally. Water contamination is one of the major causes of amphibian demise, which affects natural ecosystems in a profound way. As the natural pecking order advances, poisons like mercury, cadmium, and lead get more and more concentrated as they are eaten by marine life, causing major health problems for people and the environment.

6. What is the importance of pollution prevention?

In addition to protecting the environment by conserving and protecting natural resources, pollution prevention improves economic growth by spreading more efficient production among industries and by reducing waste management requirements for households, businesses, and communities.