Much Can Be Learned About Addressing Antibiotic Resistance from Multilateral Environmental Agreements

9 Pages Posted: 13 Dec 2015 Last revised: 11 May 2016

See all articles by Steinar Andresen

Steinar Andresen

Fridtjof Nansen Institute

Steven Hoffman

York University; Harvard University

Date Written: May 2016


One of the major global health security issues of our time is antibiotic resistance (ABR). To address this problem much can be learned from our attempts to deal with a different but serious global issue: the environment. Like the environment antibiotic effectiveness can be seen as a common good, since it is finite and it is very difficult to stop people from abusing them inappropriately. Environmental issues have traditionally been handled using multilateral environmental agreements (MEA) between partner nations, political regions, and in some cases the whole globe. Studying these agreements and understanding what works and what does not work can provide a guide of where to begin with the ABR crisis. A brief examination of environmental agreements reveals five institutional design features that appear to be very relevant to the global threat of ABR: (1) robust reporting and verification procedures; (2) must include both sanctions for non-compliance and assistance for implementation; (3) must be designed in such a way to allow maximally ambitious content; (4) should include implementation mechanisms for strengthening political decision-making and securing independent scientific advice; and (5) must contain provisions, obligations, and targets that are as specific, precise, and clear as possible.

Keywords: global, health, security, antibiotic, resistance, ABR, environment, environmental, multilateral, agreements, MEA, governance, institutional, design

Suggested Citation

Andresen, Steinar and Hoffman, Steven, Much Can Be Learned About Addressing Antibiotic Resistance from Multilateral Environmental Agreements (May 2016). Journal of Law, Medicine and Ethics, Vol. 43, No. 2, Summer 2015; Ottawa Faculty of Law Working Paper No. 2016-01. Available at SSRN:

Steinar Andresen

Fridtjof Nansen Institute ( email )

P.O. Box 326
Lysaker N-1326

Steven Hoffman (Contact Author)

York University ( email )

Global Strategy Lab
4700 Keele Street
Toronto, Ontario M3J 1P3
+1-416-736-2100 ext 33364 (Phone)


Harvard University ( email )

Department of Global Health & Population
665 Huntington Avenue, Building 1, Room 1104
Boston, MA 02115
United States


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