Antimicrobial resistance (AMR) is a natural process where microbes develop the ability to survive the antimicrobial drugs we depend upon to treat and prevent deadly infections, such as antibiotics. This microscopic evolution is further propelled by human activities, where each use of an antimicrobial drug potentially induces AMR. As microbes can spread quickly from animals to humans and travel around the world through humanity’s global circuits of movement, the use of any antimicrobial drug has potentially global consequences. As human-induced AMR occurs, mortality and morbidity increase due to increasingly or sometimes completely ineffective antimicrobial treatments. This article considers AMR as a product of the evolving and complex interplay between human societies and invisible microbial worlds. It argues that as a political challenge, AMR requires robust institutions that can manage human–microbial interactions to minimize the emergence of drug resistance and maximize the likelihood of achieving effective antimicrobial use for all. Yet, current governance systems for AMR are ill-equipped to meet these goals. We propose a conceptual paradigm shift for global AMR governance efforts, arguing that global governance could better address AMR if approached as a socioecological problem in need of sustainable management rather than solely as a medical problem to be solved. In biodiversity governance, institutions are designed to fit the biological features of the ecosystems that they are attempting to manage. We consider how a similar approach can improve global AMR governance. Employing the concept of ecological fit, which is defined as the alignment between human social systems and biological ecosystems, we diagnose 18 discrepancies between the social institutions that currently govern AMR and the ecological nature of this problem. Drawing from lessons learned in biodiversity governance, the article proposes five institutional design principles for improving the fit and effectiveness of global AMR governance.

To address the complex challenge of global antimicrobial resistance (AMR), a pandemic treaty should include mechanisms that 1) equitably address the access gap for antimicrobials, diagnostic technologies, and alternative therapies; 2) equitably conserve antimicrobials to sustain effectiveness and access across time and space; 3) equitably finance the investment, discovery, development, and distribution of new technologies; and 4) equitably finance and establish greater upstream and midstream infection prevention measures globally. Biodiversity, climate, and nuclear governance offer lessons for addressing these challenges.

Ensuring that life-saving antimicrobials remain available as effective treatment options in the face of rapidly rising levels of antimicrobial resistance will require a massive and coordinated global effort. Setting a collective direction for progress is the first step towards aligning global efforts on AMR. This process would be greatly accelerated by adopting a unifying global target — a well-defined global target that unites all countries and sectors. The proposed pandemic instrument — with its focus on prevention, preparedness and response — represents an ideal opportunity to develop and adopt a unifying global target that catalyzes global action on AMR. We propose three key characteristics of a unifying global target for AMR that — if embedded within the pandemic preparedness instrument — could rally public support, funding, and political commitment commensurate with the scale of the AMR challenge.

Global antimicrobial resistance (AMR) is currently governed by a decentralized regime complex composed of multiple institutions with overlapping and sometimes conflicting principles, norms, rules, and procedures. Such a decentralized regime complex provides certain advantages and disadvantages when compared to a centralized regime. A pandemic instrument can optimize the regime complex for AMR by leveraging the strengths of both centralization and decentralization. Existing climate treaties under the UNFCCC offer lessons for achieving this hybrid approach.

While mobility-assistive devices ease movement and independence of persons with disabilities, their use may depend on their social and symbolic meaning. This article departs from our observation that elderly people in Wakiso in Uganda own a variety of assistive technologies yet do not utilize them all equally. Our findings are based on data collected through conversations, interviews and observations of thirty elderly people visited in their homes between July 2016 and January 2017. We found that elderly people with mobility disabilities valued devices for the greater autonomy they afforded, although dependence was also valued in some situations. The source or provenance of a device imbued it with meaning. Holding onto it regardless of how much one used it was in a way like holding onto the social relationship that the artefact represented, and the same can be said of abandoning it. Devices were also valued according to the manner in which they portrayed the user to the rest of the world – either positively as cosmopolitan and cared for, or negatively as sickly.

Antimicrobial resistance (AMR) is one of the defining global health threats of our time, but no international legal instrument currently offers the framework and mechanisms needed to address it. Fortunately, the actions needed to address AMR have considerable overlap with the actions needed to confront other pandemic threats.

M. Beiglböck, V. Bergelson, and A. Fish proved that if G is a countable amenable group and A and B are subsets of G with positive Banach density, then the product set AB is piecewise syndetic. This means that there is a finite subset E of G such that EAB is thick, that is, EAB contains translates of any finite subset of G. When G = ℤ, this was first proven by R. Jin. We prove a quantitative version of the aforementioned result by providing a lower bound on the density (with respect to a Følner sequence) of the set of witnesses to the thickness of EAB. When G = ℤd , this result was first proven by the current set of authors using completely different techniques.

Erdős conjectured that for any set $A\,\subseteq \,\mathbb{N}$ with positive lower asymptotic density, there are infinite sets $B,\,C\,\subseteq \,\mathbb{N}$ such that $B\,+\,C\,\subseteq \,A$. We verify Erdős’ conjecture in the case where $A$ has Banach density exceeding $\frac{1}{2}$. As a consequence, we prove that, for $A\,\subseteq \,\mathbb{N}$ with positive Banach density (a much weaker assumption than positive lower density), we can find infinite $B,\,C\,\subseteq \,\mathbb{N}$ such that $B\,+\,C$ is contained in the union of $A$ and a translate of $A$. Both of the aforementioned results are generalized to arbitrary countable amenable groups. We also provide a positive solution to Erdős’ conjecture for subsets of the natural numbers that are pseudorandom.