Exploring the evidence base for national and regional policy interventions to combat resistance
2016
Hasan, D | Schlundt, S | Caleo, S | Rweyemamu, M | Buckle, M
An array of local, national and global policy initiatives to control antimicrobial resistance (AMR) have been launched, but the effectiveness of these policies is not yet fully understood. A stronger evidence base to inform effective policy interventions in high and low/middle income country (HIC and LMIC) settings, and across both the human and animal sectors, is needed. We examine existing policies covering three domains: 1) responsible use, 2) surveillance and 3) infection prevention and control, and consider which policies are likely to be most effective at national and regional levels. Specific case studies highlight the complexities of applying AMR prevention and control policies across sectors and in widely varying political and regulatory environments, and demonstrate gaps that have emerged in the evidence base. We make recommendations for policy action given the current state of evidence 2and demonstrate that there is a need for more comprehensive AMR control policy evaluations including of their cost-effectiveness and generalisibility; by providing a contextual analysis of the political, regulatory and technical environments in which they are implemented. This is especially important across LMICs, and in the animal and environmental sectors. We conclude that standardised frameworks for evaluating AMR control policies should be developed and a cross-sectoral open-access central repository established to capture national and regional experience. A ‘One Health’ approach would enable an inclusive, sensitive and flexible process for AMR policy development that accommodates the needs and circumstances of each sector involved, and addresses specific country and regional concerns.
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