Antimicrobial Resistance: Evolutionary Inevitability or a Human-Made Crisis?
“Where are the drugs? The drugs are where the disease is not. Where is the disease? The disease is where the drugs are not.” - Peter Mugyenyi, Ugandan physician, HIV/AIDS researcher, medical administrator and author. Few statements capture the global paradox of antimicrobial resistance more clearly than this observation from Ugandan physician Peter Mugyenyi. His words do not describe microbial genetics. They describe distribution, access and systems in healthcare and medication. The distinction matters. Antimicrobial resistance (AMR) is often framed as a biological inevitability, where microbes evolve, antibiotics lose effectiveness, and the cycle continues. This is true, but it is incomplete. Resistance is not only an evolutionary phenomenon. It has become a crisis because human systems, medical, economic, agricultural, and political avenues, amplify and mismanage evolutionary pressure. The question, then, is not whether resistance evolves. It does. The question is why it...