TY - JOUR
T1 - Setting the standard
T2 - Multidisciplinary hallmarks for structural, equitable and tracked antibiotic policy
AU - Kirchhelle, Claas
AU - Atkinson, Paul
AU - Broom, Alex
AU - Chuengsatiansup, Komatra
AU - Ferreira, Jorge Pinto
AU - Fortané, Nicolas
AU - Frost, Isabel
AU - Gradmann, Christoph
AU - Hinchliffe, Stephen
AU - Hoffman, Steven J.
AU - Lezaun, Javier
AU - Nayiga, Susan
AU - Outterson, Kevin
AU - Podolsky, Scott H.
AU - Raymond, Stephanie
AU - Roberts, Adam P.
AU - Singer, Andrew C.
AU - So, Anthony D.
AU - Sringernyuang, Luechai
AU - Tayler, Elizabeth
AU - Rogers Van Katwyk, Susan
AU - Chandler, Clare I.R.
N1 - Funding Information:
Acknowledgements We are grateful to all correspondents and participants of the 2019 workshop for sharing their insights and expertise. The workshop and activity for this manuscript was supported by the Antimicrobials in Society (AMIS) programme (https://antimicrobialsinsociety.org/). The authors would like to thank Charlotte Kirchhelle for her help in preparing the figures of this article.
Funding Information:
Competing interests SH is Scientific Director of CIHR’s Institute of Population and Public Health and CIHR’s Scientific Co-Lead for Antimicrobial Resistance. He is Director of the WHO Collaborating Centre on Global Governance of Antimicrobial Resistance. KO in principal investigator of CARB-X, a project at Boston University (my employer), funded by three governments (US, UK and Germany) and two charitable foundations (Wellcome Trust and the Bill & Melinda Gates Foundation). CARB-X is a non-profit, making grants for preclinical antibacterial research. I do not view this as a conflict, but disclose in an abundance of caution. APR is the co-ordinator of the JPIAMR funded Network NEAR-AMR. ADS reports grants from ReAct-Action on Antibiotic Resistance and from Open Society Foundation during the conduct of the study. He served as Co-Convener of the UN Interagency Coordination Group on Antimicrobial Resistance (2018–2019), as a member of the Expert Commission on Addressing the Livestock Contribution to the Antibiotic Resistance Crisis (2016–2017), as a commissioned author to the UK Commission on AMR on 'A Framework for Costing the Lowering of Antimicrobial Use in Food Animal Production' (2016), as Head of the Secretariat of the Antibiotic Resistance Coalition, and as a Member of the Working Group on Antibiotic Resistance for the President’s Council of Advisors on Science and Technology (2013–2014).
Funding Information:
Funding AMIS is funded by The Antimicrobial Resistance Cross Council Initiative supported by the seven research councils in partnership with other funders. The lead funders are the Economic and Social Research Council (ESRC) with the Department of Health and the Arts and Humanities Research Council (AHRC). Kirchhelle’s work was supported by a Wellcome Trust University Award at University College Dublin and the Oxford Martin School. Fortané was supported by INRAE (ANR-18-CE03-001), Frost by CDDEP, Nayiga by ESRC, Taylor by the UK Fleming Fund. APR would like to acknowledge funding from the AMR Cross-Council Initiative through a grant from the Medical Research Council, a Council of UK Research and Innovation (Grant Number; MR/S004793/1) Disclaimer The views expressed in this article are those of the authors and do not necessarily reflect those of CIHR, the Government of Canada, or WHO.
Publisher Copyright:
© 2020 Author(s) (or their employer(s)). Re-use permitted under CC BY. Published by BMJ.
PY - 2020/9/23
Y1 - 2020/9/23
N2 - There is increasing concern globally about the enormity of the threats posed by antimicrobial resistance (AMR) to human, animal, plant and environmental health. A proliferation of international, national and institutional reports on the problems posed by AMR and the need for antibiotic stewardship have galvanised attention on the global stage. However, the AMR community increasingly laments a lack of action, often identified as an â € implementation gap'. At a policy level, the design of internationally salient solutions that are able to address AMR's interconnected biological and social (historical, political, economic and cultural) dimensions is not straightforward. This multidisciplinary paper responds by asking two basic questions: (A) Is a universal approach to AMR policy and antibiotic stewardship possible? (B) If yes, what hallmarks characterise â € good' antibiotic policy? Our multistage analysis revealed four central challenges facing current international antibiotic policy: metrics, prioritisation, implementation and inequality. In response to this diagnosis, we propose three hallmarks that can support robust international antibiotic policy. Emerging hallmarks for good antibiotic policies are: Structural, Equitable and Tracked. We describe these hallmarks and propose their consideration should aid the design and evaluation of international antibiotic policies with maximal benefit at both local and international scales.
AB - There is increasing concern globally about the enormity of the threats posed by antimicrobial resistance (AMR) to human, animal, plant and environmental health. A proliferation of international, national and institutional reports on the problems posed by AMR and the need for antibiotic stewardship have galvanised attention on the global stage. However, the AMR community increasingly laments a lack of action, often identified as an â € implementation gap'. At a policy level, the design of internationally salient solutions that are able to address AMR's interconnected biological and social (historical, political, economic and cultural) dimensions is not straightforward. This multidisciplinary paper responds by asking two basic questions: (A) Is a universal approach to AMR policy and antibiotic stewardship possible? (B) If yes, what hallmarks characterise â € good' antibiotic policy? Our multistage analysis revealed four central challenges facing current international antibiotic policy: metrics, prioritisation, implementation and inequality. In response to this diagnosis, we propose three hallmarks that can support robust international antibiotic policy. Emerging hallmarks for good antibiotic policies are: Structural, Equitable and Tracked. We describe these hallmarks and propose their consideration should aid the design and evaluation of international antibiotic policies with maximal benefit at both local and international scales.
KW - diseases
KW - disorders
KW - health policies and all other topics
KW - infections
KW - injuries
KW - public health
UR - http://www.scopus.com/inward/record.url?scp=85092384801&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85092384801&partnerID=8YFLogxK
U2 - 10.1136/bmjgh-2020-003091
DO - 10.1136/bmjgh-2020-003091
M3 - Review article
C2 - 32967980
AN - SCOPUS:85092384801
SN - 2059-7908
VL - 5
JO - BMJ Global Health
JF - BMJ Global Health
IS - 9
M1 - e003091
ER -