Highlights

• Clinically useful antibiotics are a Iinite resource and a global, essential public good. Consumer protection and public health must not be subordinated by governments or international institutions to the pursuit of proIit.
• An ecological understanding of bacteria and their importance for human, animal and ecosystem well-being must underpin all policy and practice concerning the use of antibiotics.
• Public leadership is needed to enact new, needs-driven research and development models, with open research and transparent data, which support rational use and equitable access to antibiotics.
• National-level action is paramount, international cooperation is essential, and the collective responsibility of all stakeholders is crucial in order to bring about a solution to the escalating healthcare crisis caused by antibiotic resistance.
• Effective action on antibiotic resistance requires that the social and economic determinants of infectious diseases be addressed. In many parts of the world, these are manifested through poverty, exploitation, international power relations and local inequities, as well as through poor access to nutrition, safe drinking water and sanitation.