Antimicrobial resistance (AMR) is among the most urgent global health threats of our time.Footnote 1 During the 2024 High Level Meeting on AMR, the UN General Assembly underscored the need for “immediate action…to safeguard our ability to treat human, animal and plant diseases” and ensure “food safety, food security and nutrition…economic development, equity and a healthy environment.”Footnote 2 AMR is a naturally occurring evolutionary response, in which microbes (bacteria, viruses, parasites, and fungi) develop resistance mechanisms to antimicrobials (antibiotics, antimalarials, antiretrovirals, and antifungals) rendering these substances less effective in preventing or treating infections in plants, animals, and humans.Footnote 3 The implications of AMR for human health are significant: a systematic analysis published in The Lancet in 2022 linked bacterial AMR to 4.95 million deaths in 2019 with predictions that AMR could cost as much as 1 trillion US dollars in healthcare spending per year by 2030.Footnote 4 However, these estimates may already be outdated with the most recent World Health Organization (WHO) report indicating that “AMR has increased in 40% of the pathogen–antibiotic combinations monitored for global temporal trends between 2018 and 2023.”Footnote 5
Historically, AMR was framed as a public health issue, linked with the overuse and misuse of antimicrobials in clinical settings.Footnote 6 The primary modalities for addressing AMR centered around research and innovation, surveillance, diagnostics and treatment, and drug stewardship—all aimed at improving drug efficacy and development and reducing antibiotic overuse in health and food systems.Footnote 7 As a result, AMR beyond clinical settings and its significant interlinkages with planetary environmental crises—climate change, biodiversity loss, and pollution—were not readily visible in AMR discourse and governance.Footnote 8 Moreover, almost no consideration was given to the role of the environment or more accurately, environmental selectors—drug residues, biocides, heavy metals, and other anthropogenic pollutants—driving the emergence and spread of AMR.
The rapid acceleration of AMR, which started in the 19th century and gathered further steam during the post-World War II period, is now being linked with the same anthropogenic factors fueling the triple planetary crisis.Footnote 9 When released into the environment, antimicrobial pharmaceuticals and other selective substances (heavy metals, biocides, industrial discharge, and human waste) interact with microbes in multiple, interlocking ways, creating environments conducive to genetic mutations that enable microbes to become more resistant to antimicrobial agents.Footnote 10
When the WHO, the United Nations Food and Agriculture Organization (FAO), and the World Organization for Animal Health (WOAH, formerly known as the Office International des Épizooties) came together to form the AMR Tripartite in 2010, little attention was afforded to the environment, despite being guided by a “One Health” approach.Footnote 11 It would take another seven years before the environmental drivers of AMR would be acknowledged. This initiative would not come from the AMR Tripartite, but through the UN Environmental Assembly (UNEA) in its third session, drafting a resolution in anticipation of the High-Level Political Forum on Sustainable Development.Footnote 12 Having decided on the theme of “pollution, and being ‘firmly positioned’ as the world’s voice on the environment,” the UNEA recognized “the need to further understand the role of environmental pollution and AMR” calling on the UN Environmental Programme (UNEP) “to prepare a report on the environmental impacts of AMR” and encouraging “Member States to consider establishing measures to manage waste and wastewater to minimize contamination contributing to AMR.”Footnote 13 From this directive, the UN Environmental Programme (UNEP) produced its report Bracing for Superbugs: Strengthening Environmental Action in the One Health Response to Antimicrobial Resistance, finally joining the three agencies to form the AMR Quadripartite in 2022.Footnote 14
Despite these developments, however, the environment continues to be sidelined in favor of human health and biomedical-led responses in AMR governance. In the recent 2024 Political Declaration of the UN high-level meeting on AMR, the environment was mentioned in just five paragraphs, and with much weaker commitments compared to human health and animal health.Footnote 15 Neglecting environmental drivers in AMR governance leaves open the question of whether existing biomedical responses will be capable of addressing the “multi-scalar” dimensions of this public health crisis.Footnote 16
Drawing on recent developments within international law, this paper explores the right to a healthy environment as a normative lens to expand the narrative in AMR discourse from a global health threat to an environmental human rights crisis. The past decade has seen a groundswell of climate litigation around the world, which has not only shifted the landscape of international human rights law but also compelled States to adopt more robust measures to address the human rights dimensions of climate change and environmental degradation.Footnote 17 In recent years, a series of landmark advisory opinions from supranational courts and tribunals, along with judgments from regional human rights bodies, have recognized a right to a healthy, clean, and sustainable environment as a justiciable obligation under international human rights law.Footnote 18 In April 2024, the European Court of Human Rights issued its judgment in three climate-related applications, KlimaSeniorinnen v Switzerland, Carême v France, and Duarte Agostinho and Others v Portugal and 32 Other States, acknowledging for the first time that States have an obligation to mitigate the impact of climate change where it interferes with the enjoyment of existing human rights under the European Convention on Human Rights.Footnote 19 In May 2024, the International Tribunal on the Law of the Sea (ITLOS) issued an advisory opinion clarifying the scope and nature of States’ legal obligations in respect of climate change, and also for the first time acknowledging that “climate change represents an existential threat and raises human rights concerns.”Footnote 20 In July 2025, the Inter-American Court of Human Rights issued its own advisory opinion, recognizing that all States hold a legal obligation to take measures to address the climate emergency and prevent irreversible environmental harm, elevating this obligation to a peremptory (jus cogens) norm under international law.Footnote 21 The Inter-American Court further advanced the rights of nature, claiming that “protection of the global climate system requires safeguarding the integrity of ecosystems” both “the living and non-living components.”Footnote 22 Finally, in July 2025, the International Court of Justice issued its authoritative advisory opinion, drawing together decisions of the regional human rights bodies, the advisory opinion of ITLOS, previous resolutions of the UN General Assembly, and UN Human Rights mechanisms to consolidate the “human right to a clean, healthy and sustainable environment” as a standalone human right and an “essential pre-condition for the enjoyment of [all] other human rights.”Footnote 23
These developments signal a shifting legal landscape—one that not only acknowledges the importance of a healthy environment for the enjoyment of all rights but also recognizes States’ legal obligations to prevent, prohibit, and mitigate the impact of anthropogenic activities contributing to planetary environmental crises. Importantly, these developments push the boundaries of traditional human rights law, recognizing intergenerational equity (rights of future generations), the rights of nonhumans (rights of nature), shared or shifted burdens of proof, wider legal standing (locus standi), and exterritorial application.Footnote 24 This paper explores how, and to what end, these developments could be applied to AMR, to strengthen accountability for human-induced environmental changes contributing to AMR.
As a starting point, Part II traces the trajectory of the right to a healthy environment, arguing that this right emerged from the ground-up across three pathways: (1) through recognition in regional human rights mechanisms and within national law; (2) through the greening of existing human rights under UN treaties and regional human rights instruments; and (3) through procedural guarantees (right to information, public participation, and access to justice) embedded in environmental law.Footnote 25 Part III examines recent judgments and advisory opinions of international courts and tribunals and regional bodies, reflecting on the scope and content of the right to a healthy environment and its consolidation under international law. Part IV contemplates whether the right to a healthy environment could be applied to AMR to widen the narrative and advance more holistic approaches to AMR governance. With an emerging body of evidence demonstrating the interconnectivity between AMR and climate change, pollution, and biodiversity loss, the right to a healthy environment offers a wider set of tools to address the environmental drivers, holding State and non-State actors (such as pharmaceutical producers, agribusinesses, and waste industries) accountable for their (in)actions against AMR.Footnote 26 Moreover, with growing recognition of microbes as an essential component of human health, ecosystems, and planetary health, there may be opportunities to leverage the right to a healthy environment to advance “rights” for microbiota, implicitly recognizing the right to healthy microbial environments.Footnote 27 Importantly, we consider how the framework of a right to a healthy environment could offer avenues for those impacted by AMR and AMR-related interventions to seek justice and accountability, and more inclusive and participatory approaches in AMR governance, which move beyond public health interventions toward the equitable and sustainable governance of AMR and microbial environments. Viewed this way, the lens of environmental human rights law offers a powerful tool to draw out the distributive injustices underpinning microbial pollution and the structural inequities contributing to exposure to, harm from, and lack of regulatory oversight of environmental drivers of AMR. At the same time, we acknowledge that there remain challenges particular to AMR, such as the absence of any justiciable legal framework for AMR and a dearth of authoritative scientific evidence pinpointing the precise causal mechanisms of AMR. Nonetheless, this paper concludes that the right to a healthy environment holds promise, opening up a critical site of legal innovation: a nascent but potentially transformative pathway to advance justice and accountability in AMR governance.
1. Tracing the right to a healthy environment under international law: From a foothold in the Stockholm Declaration to an emerging human right
Despite its early foothold in the 1972 Stockholm Declaration, there is no explicit recognition of a right to a healthy environment in multilateral treaties under environmental law.Footnote 28 Similarly, there was no expressed recognition of the right to a healthy environment in the Universal Declaration of Human Rights nor in early United Nations human rights instruments.Footnote 29 While the 1989 United Nations Convention on the Rights of the Child referenced “the dangers and risks of environmental pollution” within Article 24(2)(b), it fell short of explicitly recognizing a right to a healthy environment.Footnote 30 The 2012 Declaration on the Rights of Indigenous Peoples was the only UN human rights instrument to codify “conservation and protection of the environment” as part of the right to self-determination of indigenous peoples.Footnote 31 However, as this was not a legally binding instrument, the 2012 Declaration did not create a justiciable right to a healthy environment under international law.
Notwithstanding its relative invisibility at the international level, the right to a healthy environment enjoyed wide recognition at the regional and national levels.Footnote 32 As early as 1981, the African Charter on Human and Peoples’ Rights (Banjul Charter) enshrined a right to a healthy environment, recognizing that “all peoples shall have the right to a generally satisfactory environment favorable to their development.”Footnote 33 This was followed by the 1988 Additional Protocol to the American Convention on Human Rights in the Area of Economic, Social and Cultural Rights (1988 Protocol of San Salvador), which recognized that “everyone shall have the right to live in a healthy environment.”Footnote 34 This was subsequently mainstreamed across a number of regional instruments: the 2003 Protocol to the African Charter on Human and Peoples’ Rights on the Rights of Women in Africa, the 2004 Arab Charter on Human Rights, and the 2012 ASEAN Human Rights Declaration. Footnote 35 Although the European human rights system was the only regional human rights mechanism to not expressly recognize a right to a healthy environment in its 1950 Convention for the Protection of Human Rights and Fundamental Freedoms and additional protocols, or its European Social Charter, it progressively recognized a right to a healthy environment as an integral component of the right to health, drawing on the jurisprudence of other regional human rights bodies (Banjul Commission) to justify its interpretation.Footnote 36
When the UN General Assembly adopted resolution 76/300 on July 28, 2022 (without a single dissenting vote) recognizing a human right to a healthy, clean, and sustainable environment, it was hailed as “a watershed moment in the history of rights” and a turning point for environmental human rights law.Footnote 37 But, it was not an entirely unforeseen or unexpected development. In the decades leading up to the UN General Assembly resolution, there was a groundswell of climate litigation in national courts and within regional human rights mechanisms.Footnote 38 By the time the UN General Assembly adopted its resolution in 2022, more than 100 States had embedded the right to a healthy environment within national law or constitutional law.Footnote 39 Moreover, over the past decade, national and regional courts have seen a steady increase in climate litigation cases: 884 climate litigation cases were filed worldwide in 2017 whereas, more than 3000 climate change cases were filed in the first six months of 2025.Footnote 40
Alongside this flurry of climate litigation, a gradual “greening” of human rights has also been taking place within the UN human rights mechanisms.Footnote 41 The UN Human Rights Council issued its first resolution on human rights and climate change in 2008, released its first analytical study on human rights and the environment in 2009, appointed its first Special Rapporteur on the Right to a Healthy Environment in 2012, and subsequently adopted a resolution recognizing the right to a healthy, clean, and sustainable environment in 2021.Footnote 42 Around this time, the UN treaty-monitoring bodies also began expounding on the relationship between the environment and enjoyment of human rights, notably with the UN Human Rights Committee first acknowledging that “the effects of climate change…may expose individuals to a violation of their rights” and later making a finding that State parties could be in violation of their obligations under the ICCPR in 2019.Footnote 43 The UN Committee on the Rights of the Child (CRC Committee) received a collective complaint filed by 16 children, and led by Chiara Sacchi, on September 23, 2019.Footnote 44 In its decision, Sacchi et al. v Argentina, the CRC Committee found that “climate change poses significant risks to the enjoyment of human rights protected by the Convention” and “as children…are particularly affected by climate change, both in terms of the manner in which they experience its effects and the potential of climate change to have an impact on them throughout their lifetimes…States have heightened obligations to protect children from foreseeable harm.”Footnote 45 The CRC Committee further elaborated on the scope of States legal obligations in respect of the environment in its General Comment No. 26 where it claimed that, “A clean, health and sustainable environment is both a human right itself and necessary for the full enjoyment of a broad range of children’s rights.”Footnote 46 The CRC Committee imposed clear and specific obligations on States parties to undertake “deliberate, specific and targeted steps towards achieving the full and effective enjoyment of children’s rights related to the environment, including their right to a healthy environment.”Footnote 47 It is notable that the CRC Committee drew on the 2017 advisory opinion of the Inter-American Court of Human Rights, UN resolutions (UN General Assembly and Human Rights Council), and the broad recognition of the right to a healthy environment at the national level to justify its reading-in of the right to a healthy environment into the CRC.Footnote 48 This revealed the extent to which cross-fertilization not only influenced the “greening” of existing human rights law but also contributed to the recognition of the right to a healthy environment under international law.
That the right to a healthy environment enjoyed broad support, particularly among LMICs, may explain how this right emerged outside of the traditional top-down State-led model of law-making under international law. As Dzah explains, the recognition of this right in “the Banjul Charter effectively entrenched solidarity rights in the African human rights system”—something that was not only a unique “socio-political peculiarity” of Africa but “had not been historically accounted for in the evolution of the global rights regime.”Footnote 49 In so doing, it opened up a platform for indigenous communities, civil society groups, and nongovernmental organizations to come together to challenge existing power structures, employing strategic litigation and other forms of advocacy to target rich states, extractive industries, and their collaborators.Footnote 50 As Natarajan argues “climate change is symptomatic of intensifying global systems of oppression and inequity”: “only by coming together can they force the wealthy and powerful to stop destroying the global environment.”Footnote 51 Boyle and Boyd also underscore this equity dimension, pointing to procedural rights, first recognized in the 1988 Aarhus Convention and later in regional instruments across Latin America and Africa as the most significant step toward recognition of a right to a healthy environment.Footnote 52
In the next section, we consider advisory opinions and decisions of the Inter-American Court of Human Rights, the International Tribunal on the Law of the Sea (ITLOS), the International Court of Justice (ICJ), and the European Court of Human Rights arguing that while the right to a healthy environment percolated from the ground-up, outside of traditional pathways of international law-making, it has since become entrenched under customary international law.Footnote 53
2. From recognition to justiciability: The right to a healthy environment under international law
Over the past two years, we have seen a series of landmark decisions from the Inter-American Court of Human Rights, the European Court of Human Rights, the International Tribunal for the Law of the Sea, and the International Court of Justice, which articulate the scope and content of States’ legal obligations in respect of the right to a healthy environment. Although their approaches differ in scope, doctrinal method, and normative content, they collectively affirm that all States hold legal obligations to protect and preserve the environment, which are intergenerational, transboundary, and justiciable.
2.1. The Inter-American Court of Human Rights: Advisory Opinion on the Climate Emergency - AO-32
In July 2025, the Inter-American Court issued an advisory opinion on States’ legal obligations in the context of the climate emergency.Footnote 54 This advisory opinion came at the request of the governments of Chile and Colombia and built upon the Inter-American Court’s first ground-breaking advisory opinion on the environment and human rights in 2017.Footnote 55
Issued on July 3, 2025, the second Advisory Opinion was similarly groundbreaking in at least six respects.Footnote 56 First, it reaffirmed its 2017 Advisory opinion on the right to a healthy environment as an autonomous right with collective and individual dimensions, while also affirming the right to a safe climate as one of its substantive elements, with wide extraterritorial application.Footnote 57 Second, the Inter-American Court gave a clear pronouncement on the rights of nature, claiming that nature and its components are subjects of rights “not only because of the effects that [their] degradation may have on other human rights, but because of its vital interdependence with other living organisms.”Footnote 58 In this regard, the Inter-American Court recognized that States hold a positive obligation to adopt measures that ensure the protection, restoration, and regeneration of ecosystems.Footnote 59 Third, the Court elevated the prohibition against irreversible environmental harm to the status of a peremptory (jus cogens) norm, placing it on the same level as the prohibition against torture, genocide, and slavery under international law.Footnote 60 In other words, States (and non-State actors) who fail to take sufficient steps to prevent significant and irreversible environmental harm will be seen as committing an internationally wrongful act under international law, for which there can be no defense or immunity under domestic laws.Footnote 61 Fourth, the Inter-American Court underscored the intergenerational application of the right to a healthy environment, linking States’ obligation to present and future generations.Footnote 62 Fifth, the Inter-American Court recognized intersectional rights in the context of the climate emergency, claiming that certain groups deserved heightened protection—notably children, indigenous communities, rural communities, persons with disabilities, the elderly, and women.Footnote 63 Specifically, the Inter-American Court mandated “differentiated protection” for these groups “to guarantee real equality in…[the] enjoyment of rights” and to address structural vulnerabilities, using “best practices concerning the participation of children” as well as progressive measures to enable the rights of indigenous communities.Footnote 64 Finally, the Inter-American Court underscored States’ duty to cooperate, and the need for collective responses, recognizing asymmetries in historical responsibility and economic capacities, and linking enjoyment of the right to a healthy environment with an ongoing duty to address structural vulnerabilities.Footnote 65
The 2025 Advisory Opinion was hailed as groundbreaking and remains to date the most progressive interpretation of the right to a healthy environment under international law.Footnote 66 By reaffirming a specific right to a safe climate and specifically recognizing the rights of nature, both as substantive elements of the broader right, the Inter-American Court underscored the collective dimensions of environmental rights, pushing the boundaries of traditional human rights law beyond human subjects and recognizing the inter-relationship between planetary health and the enjoyment of human rights. Its recognition of the prohibition against irreversible environmental harm as a jus cogens norm elevated ecological protection to the highest international legal obligation, placing it on the same level as the prohibitions of torture, slavery, and genocide.Footnote 67 This was significant as it removed any possibility for States to avoid or shirk from their legal obligations under the 2015 Paris Agreement or any other international environmental treaty.Footnote 68 The Inter-American Court’s emphasis on intergenerational justice, intersectional protection, and international cooperation further stretched the boundaries of individual rights-based entitlements under human rights law, underscoring the collective dimension of States’ legal obligations.Footnote 69 Finally, the Court’s reaffirmation of exterritorial application signaled its commitment to accountability, irrespective of territorial boundaries.Footnote 70 The Inter-American Court effectively positioned the right to a healthy environment within a broader framework of equity, solidarity, and justice, shifting discourse from individualist rights-based entitlements to collective responsibility, and in the process recognizing that all beings—human and nonhuman—are entitled to a healthy, clean, and sustainable environment.
2.2. The European Court of Human Rights: KlimaSeniorinnen v Switzerland; Carême v France; Duarte Agostinho and Others v Portugal and 32 Others
In contrast, the European Court of Human Rights took a much narrower reading of the right to a healthy environment in its judgment in Verein KlimaSeniorinnen v Switzerland; and its admissibility decisions in Carême v France; and Duarte Agostinho and Others v Portugal and 32 Others—all issued in early April 2024.Footnote 71
In Verein KlimaSeniorinnen Schweiz and Others v Switzerland, the Court affirmed that States do hold legal obligations under the European Convention to protect individuals from the impact of climate change.Footnote 72 While the Court did not recognize the right to a healthy environment as a standalone right, it did derive an obligation to mitigate the impact of climate change based on existing rights, recognizing systemic climate inaction as justiciable under article 8 (right to privacy) of the Convention.Footnote 73 The case had been brought by four elderly women, and a non-governmental organization—Senior Women for Climate Protection Switzerland association.Footnote 74 While the European Court dismissed the petition of the individual women on the basis that they had not demonstrated a sufficiently high risk of individual harm, it formulated a new test to grant standing to the NGO, widening standing (locus standi) on the basis that climate change is a common concern of humankind.Footnote 75 In so doing, it paved the way for more representative climate-related claims, including by youth, to be brought before the Court.Footnote 76
In Duarte Agostinho and Others v Portugal and 32 Others, six Portuguese children (supported by an NGO) brought claims against Portugal and 32 other State Parties of the Council of Europe, alleging that States’ inaction on climate change violated their rights to life (article 2), privacy (article 8), and nondiscrimination (article 14).Footnote 77 In addition to their own country, the petitioners sought to implicate States whose contribution to climate change resulted in transboundary harm within Portugal.Footnote 78 The European Court dismissed the petition on two grounds. First, the Court did recognize the transboundary harm of the 32 countries beyond Portugal, as extending extraterritorial jurisdiction to this end would lead to untenable uncertainty, effectively opening the “floodgates” to limitless petitions.Footnote 79 Second, while the Court recognized the territorial jurisdiction of Portugal, it held that the applicants had not sufficiently pursued action within national courts and thus failed to exhaust domestic remedies—a requirement for admissibility to the Court.Footnote 80
In Carême v France, the Court dismissed the application for lack of victim status.Footnote 81 Carême, a former mayor of Grande-Synthe in France, claimed that France’s inaction on climate change violated his rights to life (Article 2) and privacy (Article 8) by exposing him to potential flooding and coastal erosion. However, the Court found that among other things, Carême no longer resided in France, nor maintained any relevant links with Grande-Synthe.Footnote 82
Thus, while the European Court recognized that States hold legal obligations to protect individuals from the impact of climate change, it adopted a much narrower approach to legal standing and jurisdiction than the Inter-American Court. Moreover, the European Court was far more cautious in its interpretation of the Convention in respect of climate change and its extraterritorial application, adopting a higher evidentiary threshold to avoid opening the floodgates of legal uncertainty.Footnote 83 The Court’s trepidation can be explained, in part by its own self-imposed restraint and deference to national courts. That said, the Court’s decision in KlimaSenniorinnen remains unprecedented, both in its recognition that climate change is a “common concern of humankind” for which States hold legal obligations under the Convention, and its widening of locus standi for organizations, thus enabling more public interest litigation on climate-based rights violations to be brought before the Court.Footnote 84
2.3. International Tribunal on the Law of the Sea: Advisory opinion
In May 2024, the International Tribunal on the Law of the Sea (ITLOS) issued its advisory opinion, clarifying the scope of legal obligations to protect and preserve the world’s oceans from the impacts of climate change, such as ocean warming, sea level rise, and ocean acidification, as part of States parties’ obligations under the UN Convention on the Law of the Sea.Footnote 85 The advisory opinion arose out of a request from the Commission of Small Island States on Climate Change and International Law—a group of small island States, which came together to address the urgency and fundamental injustice posed by climate change.Footnote 86 Broadly, the Tribunal found that greenhouse gas emissions absorbed by the oceans amounted to marine pollution, and as a result, States are required to take all necessary measures to reduce GHG emissions to the fullest extent possible, in accordance with legal obligations under UNCLOS and other relevant international treaties.Footnote 87 Importantly, the Tribunal noted that “climate change represents an existential threat and raises human rights concerns.”Footnote 88
2.4. International Court of Justice: Advisory opinion
The International Court of Justice issued its advisory opinion on July 23, 2025, providing the most authoritative statement on the right to a healthy environment under international law thus far.Footnote 89 The UN General Assembly requested the advisory opinion in March 2023. While the request was brought to the General Assembly by the government of Vanuatu, it was initiated by a group of 27 law students from the University of South Pacific.Footnote 90 The advisory opinion sought to clarify two points of law: (1) the scope of States’ legal obligations to protect the climate system for present and future generations and (2) the legal consequences for failing to prevent significant harm to the climate system, particularly in respect of vulnerable communities and present and future generations.
The Advisory Opinion was significant in five respects. First, it affirmed, without any uncertainty, that the right to a healthy environment is “a precondition for the enjoyment of many human rights, such as the right to life, the right to health and the right to an adequate standard of living, including access to water, food and housing.”Footnote 91 The right to a healthy environment “results from the interdependence between human rights and the protection of the environment” and is justiciable through international human rights treaties.Footnote 92 Second, it affirmed, unequivocally, that all States hold legally binding obligations to prevent harm to the climate system and other parts of the environment, irrespective of whether States are party to one or more of climate change treaties.Footnote 93 Third, the Court clarified that States must adopt climate mitigation and adaptation measures, which include regulating the extraterritorial conduct of non-State actors for whom there is effective control, and taking into account the principle of common but differentiated responsibilities and respective capabilities.Footnote 94 Failure to take adaptation and mitigation measures could amount to an internationally wrongful act, particularly where inaction results in significant transboundary harm. The Court further clarified that the obligation to prevent harm to the climate system is erga omnes (owed to the international community as a whole) underscoring that “climate change is ‘a common concern of humankind’” and an “essential interest of all States…”Footnote 95 Fourth, the Court clarified that intergenerational equity does apply and all States must give “due regard for the interests of future generations and the long-term implications of conduct” when deciding on and implementing policies related to climate change and other parts of the environment.Footnote 96 Fifth, while the Court did not make a specific pronouncement on extraterritorial application, deferring instead to individual treaty obligations, it did underscore that international human rights law must be read concurrently with climate change treaties and other relevant environmental treaties to ensure the widest respect and protection for human rights.Footnote 97 Moreover, it underscored States’ obligations to prevent transboundary pollution forms part of rules of State responsibility under customary international law.Footnote 98 Finally, while not making specific pronouncements on evidentiary burden, the Court stated that there must be a “sufficient causal nexus between the wrongful act and injury suffered.”Footnote 99 The Court acknowledged that authoritative scientific evidence would be sufficient to establish a broad causal link between anthropogenic activities and environmental harm; however, it remained steadfast in requiring causation to be proved, calling for “an in concreto” factual assessment on a case-by-case basis.Footnote 100 The Advisory Opinion marked a watershed moment for climate justice under international law, crystallizing States’ legal obligation to uphold and protect the right to a healthy environment as a matter of human rights, collective responsibility, and intergenerational equity.
Taken together, little doubt remains over the status of the right to a healthy, clean, and sustainable environment as a legally binding obligation under international law. While the approaches of the Inter-American Court, the European Court of Human Rights, ITLOS, and the International Court of Justice differ in scope, doctrinal analysis, and interpretative ambition, they collectively affirm three core propositions. First, all States hold legally binding obligations to mitigate and remedy significant environmental harm, and specifically climate-related harm with obligations extending to future generations. Second, environmental protection is no longer regarded as a matter of political discretion or negotiation, but rather as a justiciable international obligation, which, as the Inter-American Court affirmed, can rise to the level of a peremptory (jus cogens) norm. Third, whether conceptualized as the rights of nature, the “common concern of humankind,” or obligations erga omnes, environmental harm is now understood as a shared legal responsibility, which transcends borders and demands international cooperation.Footnote 101
However, the enforceability of these judgments and advisory opinions remains uneven. Advisory opinions of the Inter-American Court, ITLOS, and the ICJ hold authoritative weight, but cannot be enforced, and as such cannot compel States’ compliance. By contrast, the judgments of the European Court of Human Rights are legally binding; yet the Court has adopted a more cautious and limited approach. Thus, while the above judgments and advisory opinions evince a broad normative shift toward recognizing the human right to a healthy environment, the extent to which these developments translate into justiciable, enforceable rights remains unclear. It will largely depend on how States internalize these obligations, and importantly, on how individuals, communities, civil society organizations, and nongovernmental organizations engage with these legal developments, both as tools for advocacy and as a platform to pursue accountability at the national, regional, and international levels.Footnote 102 Viewed this way, there is little doubt that the right to a healthy environment is a justiciable right under international law; however, its practical value will ultimately be shaped by those seeking to claim, interpret, and implement it.
3. Applying the right to a healthy environment to AMR: Crown jewel or damp squib?
Once dubbed the “missing jewel in the crown of environmental human rights,” the right to a healthy environment is now seen as a critical tool in the fight “to protect humans from global environmental challenges.”Footnote 103 But, what does the right to a healthy environment bring to international human rights law that existing rights do not already provide? And how might the right to a healthy environment be applied to AMR to advance accountability and compel more holistic and equitable responses?
We make three propositions. First, the right to a healthy environment shifts the focus to solidarity, linking the preservation of our planet to the common interests of humanity. It embraces collective rights, invoking solidarity rights to engender shared responsibility in the protection of our environment. In practical terms, it provides a platform to seek collective responses and coordinated action from governments to address complex interconnected environmental and human rights crises, such as AMR.
Second, the right to a healthy environment pushes the boundaries of traditional “human” rights, recognizing our interdependence with the environment, while also advancing nonhuman “nature” rights and intergenerational equity. By centering environmental protection as a rights-based entitlement, we move away from individual “human” rights-based claims toward collective intergenerational duties and responsibilities. This, in turn, creates wider locus standi rules, broader standards of proof, such as “precautionary,” “shared,” or “shifted burdens” with greater weight and probative value afforded to other forms of evidence, such as authoritative scientific reports and data on climate trends.
Third, the right to a healthy environment reveals the importance of equity both as an underlying principle and procedural framework in the realization of human rights. That the right to a healthy environment emerged from the ground-up through climate litigation and grassroots activism reveals the critical role that accessibility holds both in advancing access to justice and in ensuring effective remedy under international law. Children and youth, who historically were excluded from law-making processes in international law, including in the drafting of the Convention on their own rights, played an instrumental role in pushing forward the right to a healthy environment, leading social movements, filing collective petitions before the CRC Committee, bringing applications before the European Court in Duarte Agostinho, and inspiring the ICJ advisory opinion.Footnote 104 All of this was made possible through equitable and inclusive processes at the regional and international level. The Inter-American Court was hailed for its inclusivity and accessibility that shaped the hearing process in the Advisory Opinion. Hearings were held in three locations (Barbados and two locations in Brazil) involving 183 delegations, with 263 third-party interventions from 613 actors.Footnote 105 Similarly, the ICJ held two weeks of hearings in December 2024, with more actors and intervenors than any previous hearing—79 States and 12 international organizations presenting oral submissions.Footnote 106 Such inclusivity not only enhanced bottom-up approaches to international law-making, but also drew attention to the structural inequalities and vulnerabilities underpinning environmental injustice. Moreover, in empowering vulnerable groups and communities, there was greater recognition of the importance of procedural rights, resulting in wider access to information, public participation and inclusive decision-making, and more effective remedies.
In the final section, we consider how and to what end the right to a healthy environment could be applied to AMR, and whether it could yield more inclusive, equitable, and sustainable governance in the management of AMR and microbial environments.
3.1. Widening the lens: Pushing the boundaries and changing the narrative in AMR
There is a distinct advantage in applying the right to a healthy environment to AMR, in so far as it draws attention to microbial ecosystems in the management of AMR. As Kirchhelle points out, “AMR governance remains dominated by linear cause-and-effect models based on triaging and stewarding a limited number of pharmaceuticals…” but whether “these stewardship regimes are effective is unclear.”Footnote 107 Centering the health of microbiota as the basis for rights-based claims allows us to move beyond narratives of AMR as a biomedical issue to consider more broadly how humans relate to, govern, and sustain microbial environments.Footnote 108 Such an approach also embraces our interdependence with microbes and focuses on collective responsibility for mitigating AMR and preserving microbial environments.Footnote 109
Acknowledging microbial ecosystems as part of the right to a healthy environment seems obvious and indeed unavoidable when considering the constitutive role that microbes play in sustaining all life.Footnote 110 At the same time, with trillions of microbes inhabiting Earth, an overly broad reading of the right to “healthy” microbial environments, and recognition of “microbial” rights could unravel the right to a healthy environment, creating impracticable and unwieldy obligations on States.Footnote 111 The Inter-American Court underscores this point calling for an “integrated legal approach…uniting the protection of human rights and the rights of Nature within a legal framework coherently aligned with the harmonious interpretation of the pro persona and pro natura principles” [emphasis added].Footnote 112 In other words, a healthy microbial environment is an essential pre-condition for the realization of all rights, yet the rights and protection afforded to microbial environments must not be interpreted in a way that undermines protection and enjoyment of human rights.Footnote 113 Viewed this way, the right to a healthy “microbial” environment offers a useful tool to revisit AMR governance through the wider lens of sustainable management of microbial ecosystems for the common benefit of humanity and the realization of human rights.Footnote 114 With recent calls to “save the microbes to save the planet” and suggestions of AMR as signaling wider planetary stress, it may be time for AMR governance and international law to move beyond its binary framing of microbes, as either biosecurity threats or exploitable resources.Footnote 115 At the same time, there remain challenges in the governance of microbes and microbial environments. With little or no recognition of microbes under international law and only limited scientific evidence linking antimicrobial exposure and environmental AMR reservoirs with animal and human harm, it may be difficult to translate the multifactorial drivers of AMR and microbial stress into actionable policy that can yield more accountability at the national and international level.Footnote 116 That there remains no binding normative framework for AMR at the international level and, currently, no mechanism for the oversight and funding of existing national action plans further complicate the challenges that lie ahead in reconstructing AMR governance to reflect microbial governance.Footnote 117 Nonetheless, the right to a healthy environment could serve as an important normative tool to enable this shift, widening AMR governance to more collective management of wider microbial ecosystems.
This widening of ecological and equity-oriented approaches toward AMR is also in line with recent biomedical and social sciences research. In 2023, the UNEP released its first comprehensive report on the environment in AMR, underscoring the interconnectivity with climate change, biodiversity loss, and pollution.Footnote 118 Van Bavel et al. recently undertook a systemic mapping of evidence linking climate change and AMR, highlighting multiple synergies and shared drivers.Footnote 119 For example, rising water temperatures increase the abundance and diversity of antimicrobial-resistant genes, while extreme weather events, such as flooding, hurricanes and heavy rainfall, can lead to the proliferation of resistant pathogens in wastewater and floodwaters. Increased droughts can trigger wastewater reuse and shortages in access to clean water—both of which heighten exposure to infection and AMR. Intensive livestock production creates a feedback loop between GHG emissions and AMR, driving antimicrobial use in farming and agriculture. Rising sea levels and changes in salinity can lead to the emergence of resistant aquatic pathogens. Finally, climate adaptation strategies like water reuse and wastewater irrigation can inadvertently contribute to AMR, by concentrating and disseminating antimicrobial-resistant genes in water sources. These synergies are compounded by the harmful effects of pollution and human-induced environmental changes (effluent waste, industrial pollution, and dumping of toxic contaminants heavy metals), which impoverish microbial environments, creating conditions conducive to resistant gene mutation and transfer.Footnote 120 A justiciable right to a healthy environment reframes AMR beyond a global health threat, linking it with broader planetary environmental crises, and in the process opening up avenues to hold State and non-State actors accountable for contributing to the environmental drivers of AMR, through the framework of climate change and environmental harm. Both the ICJ and the Inter-American Court underscore that “the duty to prevent significant harm to the environment is not confined to instances of direct cross-border harm” but rather from a collective obligation to prevent irreversible harm to the environment.
Importantly, applying the right to a healthy environment to AMR offers a normative framework in which to anchor AMR governance within broader societal responses to the planetary environmental crises. Focusing on longer-term and persistent selective burdens also draws out the structural inequalities driving antimicrobial use and exposure to AMR alongside the role of intersectionality in AMR. As Keenan et al. point out, the burden of AMR infections in humans is differentially distributed according to social stratifiers such as age, gender, race, and socioeconomic status, and these “observed inequalities are the result of layered vulnerabilities, exposures, treatments and opportunities for care.”Footnote 121 For example, industrial sites of antimicrobial pollution are more likely to be located around or in close proximity to deprived communities, increasing the likelihood of human exposure to both toxic or harmful runoff or waste from those sites, with AMR emerging through the interaction between these substances, the communities, and the surrounding environment. Drug resistance detected in communities living near the pharmaceutical manufacturing hubs around Hyderabad in India is a prime example.Footnote 122 Yet, this “social burden” of AMR is seldom captured.Footnote 123 Davis et al. underscore this point, calling for more “focus on the structural drivers of infection and antimicrobial use” and for “interventions that move beyond narrow behavioral approaches to address poverty, precarity, access to WASH, healthcare systems and living conditions.”Footnote 124 In this regard, the right to a healthy environment provides an ideal starting point, using the lexicon of human rights to draw attention to the underlying structural inequalities driving antimicrobial use, and in the process addressing the uneven social burden of AMR. In addition, it opens the possibility of holding State actors and non-State actors accountable for their (in)action in addressing rights-based violations related to antimicrobial pollution and other environmental drivers of AMR. From a procedural justice perspective, the right to a healthy environment offers tools to vulnerable and marginalized communities to demand more inclusivity and participation in AMR governance. In short, the right to a healthy environment situates AMR governance within the framework of human rights, reframing it from a technical policy issue to one grounded in equity, justice, and justiciable legal obligations at the national and international level.
4. A turning point
The recognition of the right to a clean, healthy, and sustainable environment marks an important turning point in international law—one that redefines the relationship between human rights and the environment. That this right emerged from the ground-up, shaped by youth-led movements, indigenous communities, civil society groups, and NGOs reflects the critical role that equity and solidarity have played in advancing environmental justice, alongside transboundary and intergenerational accountability.
The right to a healthy environment transforms both the conceptual framing of AMR and the process of AMR governance. It reframes AMR from a biomedical or public health problem to a symptom of wider ecological degradation and structural inequality, centering the discourse around equity, justice, and accountability. It exposes how environmental pollution, inequitable access to clean environments, and weak regulatory frameworks drive AMR and disrupt microbiota. It also expands the range of harms and interconnectivity of planetary environmental crises by introducing more measurable and visible links between global health and (micro-)environmental harm in the context of climate change. With a rights-based framework, the right to a healthy environment also ensures procedural guarantees—access to information, participation, and justice—empowering those communities most vulnerable to and impacted by AMR with tools to access justice and demand more inclusive, transparent, and equitable decision-making.
More broadly, applying the lens of a right to a healthy environment forces us to acknowledge our interdependency with microbial environments.Footnote 125 Despite the essential role that microbes play in every facet of life, they remain unseen under the law. Recognizing microbial diversity could be a legal and moral end, paving the way for more “green” intellectual property and trade laws, while also enhancing microbial governance and ecological sustainability across legal frameworks.Footnote 126 The recent calls by the International Union of Microbiological Sciences to “save the microbes to save the planet” underscore this point, signaling the need for a micro-ecological turn in international legal frameworks.Footnote 127
Yet, there remain significant challenges in applying the right to a healthy environment to AMR. Unlike climate change, AMR lacks a coherent international normative framework. Despite the Inter-American Court’s willingness to relax evidentiary rules in relation to the climate-system and other environmental harms, the challenges of establishing causality in the microbial realm are significant. The pending creation of the Independent Panel for Evidence for Action (IPEA) against AMR marks an important step, but the science of AMR and drivers of shifting microbiota remain fluid. Meanwhile, the normative contours of this newly recognized right are still evolving.
Overcoming these challenges will not be easy. However, dismissing the right to a healthy environment as a damp squib would be premature. In contrast to preceding efforts to combat AMR, the right to a healthy environment offers the unifying language of justice, solidarity, and intergenerational equity. These principles are urgently needed to address the structural inequalities driving AMR and planetary environmental crises more broadly. Moreover, as we increasingly recognize the importance of microbes as fundamental pillars of life on Earth, the right to a healthy environment opens the door to thinking more broadly about microbial governance, and indeed the rights of microbes. Viewed this way, the right to a healthy environment may not yet be the crown jewel but it still holds promise as a more equitable and just framework for the mitigation of AMR and the management of microbial environments.
Author contribution
Conceptualization: W. B.; S. V.; C. K.
Conflicts of interest
The authors declare no competing interests.
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