Designing One Health Governance for Antimicrobial Stewardship Interventions
Antimicrobial resistance (AMR) is a problem of the global commons, whose resolution depends on coordination of collective global strategy through employing effective governance approaches and models. To address the challenges a One Health (OH) approach poses for AMR governance, we will conduct a situational, institutional, legal and impact analysis of antibiotic stewardship policies in six countries across human, animal, and environmental settings. Second, a comparative analysis will identify innovative international policy, legal, design and regulatory elements of OH governance across our high-, medium- and low-income country sample. Third, we will apply systems analysis to understand the complex relationships and contingencies inherent in antibiotic stewardship governance in local and international contexts. Finally, design-thinking principles will be employed in national workshops, informed by evidence emerging from the situational, comparative and systems analysis and engaging decision-makers and local stakeholders. Design workshops will clarify the innovations and incentives that foster a OH approach to antibiotic stewardship and inform governance mechanisms and policy solutions that rely on multi-sectoral perspectives to address AMR. A number of Knowledge Translation (KT) tools will be developed, including a Policy Brief series and a OH Governance Toolkit that will outline OH-informed governance models and identify innovations in effective governance strategies that support the development of policies, regulations and laws to improve the global commons of AMR.
- Mary E. Wiktorowicz, York University, Canada (Coordinator)
- John Paget, Netherlands Institute for Health Care Research, Netherlands (Partner)
- Marion Bordier, CIRAD, Agricultural Research for Development, France (Partner)
- Alpha Amadou Diallo, Institut Sénégalais de Recherches Agricoles (ISRA), Senegal (Partner)
- Marilen Balolong, University of the Philippines, Philippines (Partner)
- Ria Benko, University of Szeged, Hungary (Partner)
AMR is a problem of the global commons, whose resolution depends on coordination of collective global strategy. Addressing the challenges posed by AMR through a One Health approach relies on inter-sectoral policy coordination - across public health, agricultural, and environmental sectors - internationally, making stewardship complex, necessitating new approaches to policy development. Our research seeks to address these issues through a comparative analysis that will identify innovative international policy, legal and regulatory approaches in high-, medium- and low-income case study countries. We will apply systems analysis to understand the complex contingencies inherent in local and international contexts in order to clarify the manner in which national systems could better support the coordinated efforts of public health, agricultural, environmental sectors, professional groups, public and private sectors, and civil society to secure their cooperation. Design thinking workshops will leverage evidence emerging from the systems analysis by engaging governments and local stakeholders. Workshops will identify the incentives that foster a One Health approach to the governance of AB stewardship, including innovative governance approaches that support the development of regional and national policies, regulations and laws to improve the global commons. The findings will be used to advise government, industry, public health and environmental agencies on solutions that foster implementation of a One Health approach to reduce AMR.