Climate change and antimicrobial resistance are presented as two of humanity's most imminent existential threats. The introduction establishes the severity of these global problems, citing projections of devastating consequences from exceeding a 2°C temperature rise (IPCC, 2018) and the potential for 10 million annual deaths due to AMR by 2050 (O'Neill, 2016). Beyond their shared scale and urgency, CC and AMR are framed as interconnected social dilemmas where individual rationality (e.g., cheap energy from fossil fuels, effective infection treatment with antibiotics) conflicts with collective interests (preventing climate change and slowing AMR). The authors acknowledge that while fossil fuel and antibiotic alternatives are limited, current overuse is detrimental. The paper aims to systematically analyze CC and AMR through game theory, comparing theoretical assumptions with real-world complexities, and ultimately, propose effective policy strategies. Three main research questions are outlined: How do core game theory assumptions align with the realities of CC and AMR? How do these dilemmas compare in their social, political, and behavioral challenges? What policy implications arise from this analysis, and what considerations are crucial for effective policy design?

The paper reviews existing literature on climate change and antimicrobial resistance, highlighting their characterization as social dilemmas, specifically Commons tragedies. It cites work that has identified the commonalities of these problems, but notes a lack of systematic analysis and direct comparison to inform comprehensive policy recommendations. The existing literature is shown to fall short of a systematic conceptualization and direct comparison of CC and AMR to form the theoretical basis for comprehensive policy suggestions. This gap in the literature provides the rationale for the current study’s focus on a game-theoretic analysis.

The paper employs a comparative analysis grounded in game theory, specifically focusing on the 'Tragedy of the Commons' framework. It systematically examines climate change and antimicrobial resistance against key assumptions underlying Hardin's (1968) classic model. This involves a step-by-step examination of decision-makers (autonomy, symmetry), information availability, the nature of the commons (renewability, tangibility, necessity), and decision strategies (choice structures, labeling of strategies, link between action and outcome, temporal and spatial distance). The analysis compares how these theoretical assumptions hold up in the context of the real-world complexities of CC and AMR. By contrasting the theoretical ideal with empirical realities, the paper identifies discrepancies to inform the development of practical policy recommendations. The authors draw extensively on existing literature on social dilemmas, experimental economics, and policy studies related to both climate change and antibiotic stewardship.

The analysis reveals significant discrepancies between game theory's idealized assumptions and the complexities of CC and AMR. Regarding decision-makers, the authors find that real-world scenarios involve intricate networks of actors with varying levels of autonomy and influence. Unlike the simplified model, decision-making is rarely symmetrical, with “superusers” (e.g., large corporations) and “gatekeepers” (e.g., medical prescribers) playing disproportionate roles. Information asymmetry is also prevalent; many individuals lack awareness or hold inaccurate beliefs about the dilemmas. The ‘commons’ in CC and AMR are far more complex than in the simple game theory model. Unlike the finite and non-renewable resource in Hardin’s model, climate stability is a more abstract concept, and antibiotic efficacy, while potentially depletable, remains subject to scientific breakthroughs. Further complicating matters, the causal links between actions and outcomes are often probabilistic and indirect, obscuring responsibility. Both CC and AMR are marked by substantial temporal and spatial distances, weakening incentives for cooperation. In the context of AMR, labeling antibiotic use as purely “selfish” is deemed inaccurate as much overuse is driven by a physician’s concern for patient welfare. The available strategies are not simple binary choices between cooperation and defection; instead, they are characterized by nuanced decisions along continuums. Based on these findings, the authors argue for third-party intervention (often the state) to effectively manage these large-scale problems.

The findings highlight the limitations of applying simplified game-theoretic models directly to policy development for CC and AMR. The complexities of decision-maker networks, information asymmetry, and the non-binary nature of choices necessitate a more nuanced approach. The authors emphasize the need for global agreements and institutions to coordinate local initiatives. While international collaboration is vital, the paper cautions against overreliance on such agreements; successful implementation requires complementary national and local actions. Targeting “superusers” through enhanced transparency and reputation mechanisms is suggested, alongside focusing on “gatekeepers” in contexts like antibiotic prescribing. The discussion emphasizes the critical need to acknowledge the limitations of applying theoretical models directly to policy decisions for such complex, large-scale real-world problems.

The paper concludes that while the Tragedy of the Commons provides a useful framework for understanding CC and AMR, its limitations must be considered when designing policy. Global agreements are essential, but national and local-level actions are equally crucial. Strategies should target influential groups, such as superusers and gatekeepers, and utilize varied administrative designs incorporating rewards and punishments. The limitations of solely punitive policies, especially concerning AMR, are underscored. While information campaigns may have limitations on their own, they are important to shaping public awareness and influencing social norms. Further research could explore the specific mechanisms by which information and social norms can effectively mitigate these collective action problems.

The paper acknowledges the inherent limitations of its theoretical analysis. While providing a valuable framework, the game-theoretic approach simplifies the real-world complexities of CC and AMR. The study focuses predominantly on theoretical analysis and policy implications; further empirical research is needed to test the effectiveness of the suggested policy recommendations. The authors acknowledge that real-world complexities may influence the generalizability of the findings.