The resistance we fuel: ethics, consumption, and the future of antibiotics.

What we put on our plates reveals what we still need to address. Antimicrobial resistance, that is, the ability of bacteria to survive antibiotics, has ceased to be a technical problem confined to laboratories and has become a civilizational threat. It is a reflection of how we eat, produce, care for, and make decisions.

The World Health Organization (WHO) classifies antimicrobial resistance (AMR) as one of the ten greatest threats to global public health. According to The Lancet, in 2019, more than half a million Europeans died due to bacterial resistance and infections caused by resistant microorganisms. And in Portugal, it is estimated that in 2019, more than two thousand deaths were directly attributed to AMR, with antibiotic consumption above the European average.

The most recent data from the European Centre for Disease Prevention and Control (ECDC) confirms that Klebsiella pneumoniae resistance to carbapenems has increased by more than 50% since 2019. Without a coordinated response, the European Union will not meet its reduction targets by 2030. At the same time, the economic dimension is also alarming. The Organisation for Economic Co-operation and Development (OECD) estimates that productivity losses and healthcare costs related to antimicrobial resistance reach approximately €12 billion annually in the EU. And 60% of antibiotic sales in the region continue to be for veterinary use, often outside of therapeutic contexts.

According to the FAO, around 70% of antibiotics produced worldwide are used in livestock farming, not so much to treat diseases, but to accelerate growth or prevent infections in intensive systems. Traces of these compounds reach the consumer's plate and seep into the soil, rivers, and ecosystems. AMR has thus already been detected in European surface waters, proving that this is an environmental, social, and moral problem, not just a clinical one.

This is where the role of universities and research centers becomes crucial. These institutions cannot remain as observers. They must work in a network with society, public decision-makers, and all actors in the system, from patient associations to the food industry, including regulatory bodies and national public health plans.

They are also responsible for promoting health literacy campaigns, raising awareness about the responsible use of antibiotics, and translating scientific knowledge into conscious and sustainable attitudes. Universities with hospitals, clinics, or senior residences have an added responsibility: these are spaces where science, practice, and community intersect daily. Thus, their role is simple: to lead change and build bridges between research, policy decision-making, and people's lives.

The One Health concept perfectly embodies this vision: the interdependence between human, animal, and environmental health. Only an integrated approach can provide concrete answers, bacterial surveillance programs, community education projects, trials of new molecules and digital technologies, and policies that prevent rather than cure. The Lancet itself reminds us that innovation cannot focus solely on new antibiotics, but also on vaccines, early diagnosis, sanitation, hygiene, and education—pillars of an ethical and sustainable strategy.

But no university can do it alone. Combating antimicrobial resistance requires alliances, cooperation, and a new scientific ethic. It's necessary to move beyond the comfort of isolated research and into the realm of shared action. Social impact projects that bring science and community closer together are fundamental to promoting healthy and conscious lifestyles. And scientific ethics are not a footnote in reports; they are at the heart of decisions. When economic efficiency triumphs over ethical prudence, and immediate profit takes precedence over the common good, the meaning of research is lost. Science should serve society, not the other way around.

Today, the true antidote to antimicrobial resistance is not a new antibiotic, but a new attitude from everyone involved. We need an ethical pact among the various stakeholders . We need to transform data into policies and knowledge into commitment. Antimicrobial resistance is a reflection of our choices.

The texts in this section reflect the personal opinions of the authors. They do not represent VISÃO nor reflect its editorial stance.