System archetypes to examine antimicrobial resistance and inform One Health governance

Antimicrobial resistance (AMR) is a growing global threat to the health of humans, animals and ecosystems. While resistance arises from biological mechanisms, its emergence and spread are shaped by interactions among ecological, social and governance processes operating within One Health systems. Systems thinking provides a framework for understanding this complexity and identifying opportunities for intervention. In this perspective, we apply four system archetypes to examine recurring feedback structures that contribute to the persistence of AMR and highlight potential leverage points for action. The Success to the Successful and Tragedy of the Commons archetypes illustrate how structural inequalities and collective action challenges can erode antimicrobial effectiveness within human and animal health. The Fixes that Fail archetype highlights how short-term, symptomatic responses such as inadequate antimicrobial disposal may generate unintended consequences that reinforce resistance over time. The Growth and Underinvestment archetype demonstrates how insufficient investment in diagnostics, surveillance, stewardship and infection prevention can constrain long-term AMR response capacity and accelerate resistance. Together, these archetypes provide a systems lens for understanding persistent drivers of AMR and identifying opportunities for coordinated, preventive and equitable approaches to stewardship and governance.