Description
Complex interdependencies among natural disasters, environmental degradation, conflicts and structural inequities have become more evident in recent years. These interdependencies exacerbate global health inequities as – under their cascading impacts – governments and national health systems are often unable to adapt to and address sustained levels of fragility, instability and insecurity. The compounding effects of these systemic and intertwined global health threats also induce forced migration, pandemic diseases and antimicrobial resistance (AMR). Interconnected at the global scale by accelerating patterns of human activity - of which urbanization can be considered one of its most pervasive forms and processes - these global health threats impact human-animal-environmental health systems, putting new populations and the systems in which these threats manifest at increased systemic risk.
The objective of our presentation is to propose the utilization of Urban Political Ecology (UPE) as a theoretical framework for assessing under-exposed urban dimensions of AMR, and for informing shared One Health (OH) governance approaches fostering more collaborative, equitable and sustainable approaches to address systemic threats. A UPE lens allows us to consider the urban dimension of global health threats as a ubiquitous spatial scale and interpretive frame to inform complex approaches addressing AMR and climate change.
Two tenets of UPE scholarship are introduced to structure the way in which UPE can inform AMR governance strategies: rescaling socioecological governance arrangements that seek to address AMR externalities, and redressing human-animal-environmental relations by considering the health inequities and environmental injustices accelerating AMR.
These theoretical insights inform a strategic approach focused on identifying shared Antimicrobial-Environmental governance pathways to address these related threats. In a world increasingly interconnected by urbanization processes and forms that profoundly rescale human-nature relations and the subsequent unequal global distribution of resources, addressing emerging and interdependent global health threats under these conditions demands an analytic framework that falls outside traditional global health governance. AMR, pandemics, biodiversity loss and climate change are examples of threats which require effective mobilization of shared governance approaches that consider the interdependencies at multiple scales.
A UPE lens not only addresses the structural determinants of AMR as local and global drivers, it also situates them in relation to planetary urbanization forces and to existential threats addressed in commitments to pandemic prevention and environmental stewardship. Advancement of shared governance pathways through a “whole of government” approach informed by a UPE lens presents an opportunity to engage global and local forces shaping the co-determinants of antimicrobial threats and environmental degradation, shedding light on how AMR and other systemic threats may be addressed through integrative policy and practice.
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