The water-energy-health nexus is one of the most important intersectional systems in sustainable development. This project is to focus such nexus on sewage treatment, while current wastewater treatment processes require energy inputs and could not remove antibiotics effectively. An estimated 700,000 people die each year from drug-resistant infections. This research project is to develop a novel anaerobic fluidised-bed bioreactor (AFR) for simultaneous effective degradation of sulfonamides, a common-used antibiotic, energy generation in the form of methane, and reclaimed water recovery. This reactor type has demonstrated high effluent quality at retention times similar to conventional wastewater treatment processes, however, with the benefit of high pharmaceutical removal and sufficient methane production to balance operational power demands. This is hypothesised to be due in part to direct interspecies electron transfer (DIET) via the granular conductive activated carbon (GAC) media used in AFBR. By understanding on sulfonamides degradation pathway and its resistant genes occurrence using novel meta-omics analyses, an investigative method will be developed that may be applicable to other antibiotic classes, leading to further developments in effective pharmaceutical removal, resistant gene mitigation, and energy generating techniques. In this project, we will address the two global challenges of energy and antibiotics resistance posed in sewage within EPSRC Remit, offering a double benefit for the water industry and health. The outcomes will help to reach UK net zero emission as set out as law in 2050 and UK's 2019-2024 antibiotics resistant genes action plan.