Mapping global policy discourse on antimicrobial resistance

Abstract

The rising importance of antimicrobial resistance (AMR) to the global health agenda is associated with a growing number of parties voicing their concern about the issue. With more recommendations and policies appearing, understanding the policy process requires making sense of the views, values, interests and goals of each participant. Policy frame analysis provides a method to understand both the scientific view and the actions advocated by global health actors to tackle AMR. Here we review and refine policy frame analyses of AMR using a deductive approach. Among several policy frames previously defined in the field of global health, we identify ‘AMR as healthcare’, ‘AMR as development’, ‘AMR as innovation’ and ‘AMR as security’ as frequent frames used in dealing with AMR. In addition, we found that ‘AMR as One Health’ constitutes a recent framing of the topic that seeks to provide an integrated understanding between human and animal health. Each frame originates in distinct scientific fields, conceptualises the main causes of AMR and prioritises different interventions and measurements. Better understanding and integration of these frames into an overarching social and ecological framework will support policy progress in tackling AMR.

Combating Antimicrobial Resistance in Singapore: A Qualitative Study Exploring the Policy Context, Challenges, Facilitators, and Proposed Strategies

“…First, it is important to understand how AMR has been socially constructed in Singapore and how power relations operate between the different stakeholders. Wernli et al distinguished five different frames that map the global policy discourse on AMR [26]. These are: a One Health approach combining in one paradigm human, animal, and environment health; a health security threat giving rise to the global health security agenda; a healthcare policy issue with the dominance of the medical profession; a development issue where it is considered that low-and-middle income countries drive AMR; and an innovation issue with a focus on new diagnostics and antibiotics.…”

Articulating citizen participation in national anti-microbial resistance plans: a comparison of European countries

“…Some previous experiences including citizens' juries examining health policy 33 or elected health boards 34 could serve as templates for such participation at different levels. A recent review of AMR policy narratives 35 , however, placed the general public as actors within the 'AMR as a healthcare problem' model only, which may therefore circumscribe their participation within AMR efforts to a 'patient' identity, likely to be passive and expected to obey, rather than share decide, clinical mandates. 36 Indeed, the most frequently identified term in our study was 'patient', followed by the 'public'.…”

Knowing antimicrobial resistance in practice: a multi-country qualitative study with human and animal healthcare professionals

“…Public health; antibiotic prescribing; antibiotic dispensing; antimicrobial resistance; healthcare professionals Background Antimicrobial Resistance (AMR) is a global problem [1], rising in both biological prevalence and global health strategy prominence [2]. Resistance to antimicrobial medicines can be seen across both human and animal populations, linked to their increasing consumption for medical purposes of disease treatment [3] and their use as growth promoters in livestock husbandry and agriculture [4][5][6].…”