Making the Invisible Visible: New report explores goal conflicts between ABR and the SDGs

2026-11-12

What happens when policies designed to achieve one important goal unintentionally make another goal harder to achieve? This question was at the center of the online workshop Making the Invisible Visible, held in April 2026 within the framework of the BRIDGE-ABR project, led by ReAct Europe and Stockholm Resilience Centre with support from the Uppsala University Future Institutes (UuniFI) Goal Conflicts initiative.

Image: ReAct.

Bringing together experts from health, agriculture, food systems, environment, development and governance, the workshop explored an often-overlooked challenge in antibiotic resistance policy: goal conflicts. Here you can access the summary of the workshop and a policy brief as well.

Beyond the health sector

While antibiotic resistance (ABR) is increasingly recognized as a major global health threat, discussions often focus on technical solutions within the health sector. Yet many of the factors driving resistance are shaped by broader development policies. Likewise, efforts to address antibiotic resistance can have implications for food security, livelihoods, access to healthcare, environmental protection and economic development. The workshop was therefore organized to map and explore what goal conflicts, or trade-offs, arise when trying to balance antibiotic resistance policies with development policies related to wider human health, agri-food systems, economic growth, or environmental protection? And how can policymakers navigate situations where different societal goals pull in different directions?

When good policies create unintended consequences

A key insight from the workshop was that goal conflicts are often difficult to see. At the level of policy objectives, antibiotic resistance and sustainable development goals frequently appear aligned. Stronger health systems, improved water and sanitation, resilient food systems and poverty reduction can all contribute to preventing infections and reducing the need for antibiotics.

Tensions during implementation

However, participants highlighted that tensions often emerge during implementation. For example:

• expanding healthcare access may improve equity and health outcomes, but can also increase antibiotic use if diagnostic services and stewardship systems are weak.
• Agricultural intensification may improve food security and incomes while simultaneously increasing disease risks and dependence on antimicrobials.
• Wastewater reuse can help address water scarcity but may create new pathways for the spread of resistant bacteria if treatment and monitoring do not keep pace.

These examples illustrate a central message from the workshop: policies that are individually beneficial can sometimes create unintended consequences when viewed through a wider systems lens.
Bringing diverse perspectives together

Mapping trade-offs with the goal conflict explorer

The workshop built on previous research by Luong Nguyen Thanh (1), examining interactions between antibiotic resistance policies and the Sustainable Development Goals (SDGs). Participants used a prototype of the Goal Conflict Explorer, a tool developed within the project to help visualize relationships between AMR and development objectives across sectors.

Wide discussions and practical examples

Through discussions covering human health, agriculture and food systems, economy and equity, and environment and climate action, participants shared practical examples from different regions of the world. Although the specific contexts varied, several common themes emerged: limited awareness of antibiotic resistance, fragmented governance structures, competing priorities and resource constraints often make trade-offs difficult to identify and manage.

At the same time, the discussions identified many opportunities for achieving synergy effects. Investments in water and sanitation, infection prevention, vaccination, biosecurity, diagnostics, education and effective governance were repeatedly highlighted as interventions capable of delivering benefits across multiple sectors simultaneously.

Looking ahead: from reacting to anticipating

One of the report’s key conclusions is that policymakers need to move beyond responding to problems after they emerge and instead take a more anticipatory approach.

Systems thinking

Drawing on systems thinking, and specifically by adapting insights from the “Anthropocene traps” (2) framework, the report describes how beneficial policies can gradually become associated with unintended consequences that are difficult and costly to reverse. As systems expand and dependencies become entrenched, options for change may narrow. Identifying potential trade-offs early can therefore be far more effective than attempting to correct them later.

From concept to indicators

While this perspective offers a promising way to understand how goal conflicts develop, its application to antibiotic resistance and sustainable development requires further empirical validation. A key question is how to operationalize the concept into measurable indicators that can show where a system stands in the development of a goal conflict, whether harmful dependencies are becoming entrenched, and where opportunities to intervene remain.

Five priorities for policymakers

As countries update their National Action Plans on AMR and discussions on the post-2030 development agenda gain momentum, the report identifies five priority areas for action:

• Integrate AMR considerations more systematically across sustainable development policies and planning processes.
• Screen major policies and investments for potential AMR-related trade-offs before implementation.
• Strengthen collaboration, coordination and learning between health, agriculture, environment, finance and development actors.
• Ensure that the costs and benefits of sustainability transitions are distributed fairly, particularly for vulnerable and low-capacity groups.
• Prioritize and fund integrated interventions that deliver benefits across multiple sectors, such as water and sanitation, infection prevention, vaccination, biosecurity and safe waste management.

A call for multi-sectoral governance

The workshop reinforced that antibiotic resistance is not only a health issue. It is also a governance, development and sustainability challenge. Making hidden trade-offs visible will not eliminate all trade-offs. However, it can help policymakers make more informed decisions, avoid unintended consequences and identify opportunities where investments can deliver benefits across multiple goals at the same time. It is an important first step toward finding solutions that work across sectors and over the long term.

References

1) Nguyen Thanh, Luong, et al. “‘When global health meets global goals’: assessing the alignment between antimicrobial resistance and sustainable development policies in 10 African and Asian countries.” BMJ Global Health 10.3 (2025): e017837. https://gh.bmj.com/content/10/3/e017837
Nguyen Thanh, Luong, et al. “A Large Language Model approach to quantify interactions between AMR and SDG action: Knowledge for seeking synergy solutions.” (2025). https://www.diva-portal.org/smash/record.jsf?pid=diva2%3A2004173&dswid=6681

2) Søgaard Jørgensen, Peter, et al. “Evolution of the polycrisis: Anthropocene traps that challenge global sustainability.” Philosophical Transactions of the Royal Society B: Biological Sciences 379.1893 (2024). https://royalsocietypublishing.org/rstb/article/379/1893/20220261/109396/Evolution-of-the-polycrisis-Anthropocene-traps